Provider Demographics
NPI:1992807341
Name:HRYNIEWICKI, THOMAS ANDREW (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANDREW
Last Name:HRYNIEWICKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1622
Mailing Address - Country:US
Mailing Address - Phone:714-997-2899
Mailing Address - Fax:714-289-7062
Practice Address - Street 1:845 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1622
Practice Address - Country:US
Practice Address - Phone:714-997-2899
Practice Address - Fax:714-289-7062
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA51721Medicare UPIN
CAG50543AMedicare PIN