Provider Demographics
NPI:1902995236
Name:CZAPLICKI, CAROLYN DANA (DO)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:DANA
Last Name:CZAPLICKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6537 CERTA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3211
Mailing Address - Country:US
Mailing Address - Phone:310-377-4237
Mailing Address - Fax:
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4909
Practice Address - Country:US
Practice Address - Phone:310-326-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6605208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics