Provider Demographics
NPI:1699791178
Name:MUCHOWSKI, KAREN (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MUCHOWSKI
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 1:225 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4249
Mailing Address - Country:US
Mailing Address - Phone:760-291-6700
Mailing Address - Fax:951-294-9039
Practice Address - Street 1:31795 RANCHO CALIFORNIA RD STE B-700
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-2993
Practice Address - Country:US
Practice Address - Phone:760-291-6700
Practice Address - Fax:951-294-9039
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20723207Q00000X
WAMD00041586207Q00000X
CAC54621207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8241044Medicaid
CACA197274OtherNORTHERN MEDICARE PTAN
WA8241044Medicaid
WAGAB32658Medicare PIN