Provider Demographics
NPI:1609145549
Name:TREDER KAWECKI, JOANNA (MD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:TREDER KAWECKI
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 1:13053 MAXWELL DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-0919
Mailing Address - Country:US
Mailing Address - Phone:714-508-9292
Mailing Address - Fax:
Practice Address - Street 1:13053 MAXWELL DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-0919
Practice Address - Country:US
Practice Address - Phone:714-508-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38926207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology