Basic Information
| Provider Information | |||||||||
| NPI: | 1487649711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KULAWIAK | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | WHOOLEY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1970 BENT TREE PL | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954041500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075680902 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1300 N DUTTON AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7073965151 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 07/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A66816 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.