NPIMap

Organization Active NPI

Eugene J Nowak DO Inc

  • Dermatopathology Physician
  • Chula Vista, CA
National Provider Identifier
1750411427
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
20A7103 Issued in CA
Legal business name
EUGENE J NOWAK DO INC
Practice address
2440 Fenton St.
101
Chula Vista, CA 91914
Phone
(619) 420-1840
Fax
(619) 420-9630
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eugene James Nowak, DONPI 1619055878
Title
President
Phone
(619) 420-1840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0900X 20A7103 CA Primary

Addresses

Primary practice location

2440 Fenton St.
101
Chula Vista, CA 91914

Mailing address

PO Box 210160
Chula Vista, CA 91921-0160
Phone (619) 420-1840

Other identifiers 1

IdentifierTypeStateIssuer
00AX71030MedicaidCA

National Provider Directory

National Provider Directory

Locations

2440 Fenton St
#101
Chula Vista, CA 91914
Phone (619) 420-1840

336 Oxford St
Ste 101
Chula Vista, CA 91911
Phone (619) 420-1840

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750411427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210160",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919210160",
            "telephone_number": "619-420-1840",
            "fax_number": "619-420-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 FENTON ST.",
            "address_2": "101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91914",
            "telephone_number": "619-420-1840",
            "fax_number": "619-420-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE J NOWAK DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOWAK",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-420-1840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "20A7103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX71030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.