Provider Demographics
NPI:1174327787
Name:NICOLAS A WOZMAK MD A PC
Entity type:Organization
Organization Name:NICOLAS A WOZMAK MD A PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WOZMAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-395-9327
Mailing Address - Street 1:335 W M ST
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-2707
Mailing Address - Country:US
Mailing Address - Phone:858-395-9327
Mailing Address - Fax:719-283-7966
Practice Address - Street 1:4 FINANCIAL PLZ
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3043
Practice Address - Country:US
Practice Address - Phone:858-395-9327
Practice Address - Fax:719-283-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty