Provider Demographics
NPI:1801067897
Name:CHMIELOWSKI, BARTOSZ (MD, PHD)
Entity type:Individual
Prefix:
First Name:BARTOSZ
Middle Name:
Last Name:CHMIELOWSKI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10945 LE CONTE AVE
Mailing Address - Street 2:UCLA, DIVISION OF HEMATOLOGY-ONCOLOGY, PVUB SUITE 2333
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-3000
Mailing Address - Country:US
Mailing Address - Phone:310-206-1214
Mailing Address - Fax:310-829-6192
Practice Address - Street 1:10945 LE CONTE AVE
Practice Address - Street 2:UCLA, DIVISION OF HEMATOLOGY-ONCOLOGY, PVUB SUITE 2333
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3000
Practice Address - Country:US
Practice Address - Phone:310-829-5471
Practice Address - Fax:310-829-6192
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89689207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A896890Medicaid
I13581Medicare UPIN
CA00A896890Medicaid