Joanna Tukaj, M.D., Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A051499 Issued in CA

Legal business name

JOANNA TUKAJ, M.D., INC.

Practice address

130 W Route 66
Ste324
Glendora, CA 91740-6252

Phone

(626) 914-0017

Fax

(626) 914-0288

NPI assigned

Aug 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Krzysztof Tukaj

Title

Secretary/Bus.Ofc.MGR

Phone

(909) 394-0828

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• DR JOANNA'S KIDS MEDICAL CLINIC Doing business as

Locations

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1477545556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W ROUTE 66",
            "address_2": "STE324",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406252",
            "telephone_number": "626-914-0017",
            "fax_number": "626-914-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W ROUTE 66",
            "address_2": "STE324",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406252",
            "telephone_number": "626-914-0017",
            "fax_number": "626-914-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNA TUKAJ, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "TUKAJ",
        "authorized_official_first_name": "KRZYSZTOF",
        "authorized_official_title_or_position": "SECRETARY/BUS.OFC.MGR",
        "authorized_official_telephone_number": "909-394-0828",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A051499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A514990",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE-1 NPI",
            "identifier": "1336407923",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR JOANNA'S KIDS MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.