Provider Demographics
NPI:1942941315
Name:KRZECZOWSKI, RACHEL M (DO)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:M
Last Name:KRZECZOWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:222 N PACIFIC COAST HWY STE 1420
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-5648
Mailing Address - Country:US
Mailing Address - Phone:877-878-3289
Mailing Address - Fax:
Practice Address - Street 1:222 N PACIFIC COAST HWY STE 1420
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-5648
Practice Address - Country:US
Practice Address - Phone:877-878-3289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10078492208600000X
CA22901208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery