Provider Demographics
NPI:1063523942
Name:OGORKIEWICZ, ALICJA (MD)
Entity type:Individual
Prefix:
First Name:ALICJA
Middle Name:
Last Name:OGORKIEWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OLD RIVER RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9504
Mailing Address - Country:US
Mailing Address - Phone:661-664-9600
Mailing Address - Fax:661-664-9699
Practice Address - Street 1:500 OLD RIVER RD
Practice Address - Street 2:SUITE 170
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9504
Practice Address - Country:US
Practice Address - Phone:661-664-9600
Practice Address - Fax:661-664-9699
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42404207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A424040Medicare PIN
CAE02529Medicare UPIN