Active NPI
Keith Kowalczyk, DC
- Chiropractor
- Pasadena, CA
National Provider Identifier
1992205348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34122
- Practice address
- 1450 N Lake Ave
Pasadena, CA 91104-2301 - Phone
- (626) 798-7805
- Fax
- (626) 798-7800
- NPI assigned
- Feb 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 34122 | CA | Primary |
Addresses
Primary practice location
1450 N Lake Ave
Pasadena, CA 91104-2301
Mailing address
1450 N Lake Ave
Pasadena, CA 91104-2301
Phone (626) 798-7805
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518393600000",
"number": "1992205348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 N LAKE AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911042301",
"telephone_number": "626-798-7805",
"fax_number": "626-798-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 N LAKE AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911042301",
"telephone_number": "626-798-7805",
"fax_number": "626-798-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOWALCZYK",
"first_name": "KEITH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-12",
"last_updated": "2018-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "34122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.