Provider Demographics
NPI:1841390051
Name:WRONSKI, CRAIG JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:JOSEPH
Last Name:WRONSKI
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 1:18811 HUNTINGTON
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648
Mailing Address - Country:US
Mailing Address - Phone:562-866-1895
Mailing Address - Fax:562-866-5730
Practice Address - Street 1:18811 HUNTINGTON
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648
Practice Address - Country:US
Practice Address - Phone:714-687-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A55602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX55600Medicaid
CA20A5560OtherBLUE SHIELD
F53686Medicare UPIN
CA20A5560OtherBLUE SHIELD