Provider Demographics
NPI:1750389177
Name:KREPAK, DONNA (DO)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:KREPAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:29645 RANCHO CALIFORNIA RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6200
Mailing Address - Country:US
Mailing Address - Phone:951-506-6554
Mailing Address - Fax:951-506-6574
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD
Practice Address - Street 2:SUITE 210
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6200
Practice Address - Country:US
Practice Address - Phone:951-506-6554
Practice Address - Fax:951-506-6574
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7199208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics