Individual provider Active NPI

Krzysztof M Kuczkowski, MD

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1063453306
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A73507 Issued in CA
Practice address
200 West Arbor Drive
Ucsd Medical Center MC 0801
San Diego, CA 92103-0801
Phone
(619) 543-5720
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A73507 CA Primary

Addresses

Primary practice location

200 West Arbor Drive
Ucsd Medical Center MC 0801
San Diego, CA 92103-0801

Mailing address

8720 Villa la Jolla Dr
La Jolla, CA 92037-1920
Phone (858) 638-8168

Other identifiers 1

IdentifierTypeStateIssuer
00A735070MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A73507CAMDAnesthesiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063453306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 VILLA LA JOLLA DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371920",
            "telephone_number": "858-638-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WEST ARBOR DRIVE",
            "address_2": "UCSD MEDICAL CENTER MC 0801",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921030801",
            "telephone_number": "619-543-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCZKOWSKI",
        "first_name": "KRZYSZTOF",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A73507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A735070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.