Provider Demographics
NPI:1922472497
Name:KOWALKOWSKI, ALLISON (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:KOWALKOWSKI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10078 PASEO MONTRIL
Mailing Address - Street 2:#716
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3941
Mailing Address - Country:US
Mailing Address - Phone:219-798-3386
Mailing Address - Fax:
Practice Address - Street 1:1670 MAIN ST
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-5240
Practice Address - Country:US
Practice Address - Phone:760-788-7074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74105183500000X
IN26026252A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist