Provider Demographics
NPI:1447321880
Name:TOSCZAK, KRISTOFER WILLIAM (DC)
Entity type:Individual
Prefix:MR
First Name:KRISTOFER
Middle Name:WILLIAM
Last Name:TOSCZAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 VIA CTR STE B
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6056
Mailing Address - Country:US
Mailing Address - Phone:760-758-3432
Mailing Address - Fax:760-639-4325
Practice Address - Street 1:1938 VIA CTR STE B
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6056
Practice Address - Country:US
Practice Address - Phone:760-758-4325
Practice Address - Fax:760-639-4325
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
W19189Medicare ID - Type Unspecified