Provider Demographics
NPI:1326172685
Name:JANIKOWSKI, JOHN EDWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:JANIKOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1702
Mailing Address - Street 2:A.P.O. A.P. 96555
Mailing Address - City:A.P.O.
Mailing Address - State:CA
Mailing Address - Zip Code:96555
Mailing Address - Country:US
Mailing Address - Phone:805-355-2223
Mailing Address - Fax:
Practice Address - Street 1:BLDG 603 OCEAN ROAD
Practice Address - Street 2:A.P.O. A.P. 96555
Practice Address - City:A.P.O.
Practice Address - State:CA
Practice Address - Zip Code:96555
Practice Address - Country:US
Practice Address - Phone:805-355-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1064207Q00000X
CA2OA 5168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine