Provider Demographics
NPI:1861484651
Name:OLSZOWKA, ANGELIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELIQUE
Middle Name:
Last Name:OLSZOWKA
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:PO BOX 500231
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92150-0231
Mailing Address - Country:US
Mailing Address - Phone:858-385-1431
Mailing Address - Fax:
Practice Address - Street 1:BLDG H100 SANTA MARGARITA ROAD
Practice Address - Street 2:ATTENTION: CODE CS-PA
Practice Address - City:CAM PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-1330
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA643772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology