Gregory T Antkowiak
Geriatric Medicine
2810 Camino Del Rio S Ste 102
San Diego
, California 92108-3818
Gregory T Antkowiak
Geriatric Medicine
2810 Camino Del Rio S Ste 102
San Diego
, California 92108-3818
(858) 461-6008
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Gregory T Antkowiak
- 2810 Camino Del Rio S Ste 102
- San Diego, CA
- Zip : 92108-3818
- Fax : (858) 461-6008
- Phone : (619) 299-1419
Second Address
- Gregory T Antkowiak
- 2810 Camino Del Rio S Ste 102
- San Diego, CA
- Zip : 92108-3818
- Fax : (858) 461-6008
- Phone : (619) 299-1419
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | A78990 | CA |
National Provider Identifier
| NPI | 1154307775 |
|---|---|
| Provider Name | Gregory T Antkowiak |
| First Address | San Diego, CA 92108-3818 |
| Second Address | San Diego, CA 92108-3818 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/12/2005 |
| Last Update Date | 18/12/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| I00826 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.