Provider Demographics
NPI:1730203050
Name:GOSEK, EWA (MD,)
Entity type:Individual
Prefix:DR
First Name:EWA
Middle Name:
Last Name:GOSEK
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:EWA
Other - Middle Name:
Other - Last Name:SZPITEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 944
Mailing Address - Street 2:889 E FRANCIS DR. SUITE A
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-0944
Mailing Address - Country:US
Mailing Address - Phone:760-861-0276
Mailing Address - Fax:760-301-0070
Practice Address - Street 1:889 E FRANCIS DR
Practice Address - Street 2:SUITE A
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-2213
Practice Address - Country:US
Practice Address - Phone:760-861-0276
Practice Address - Fax:760-301-0070
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0501872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202316519Medicaid
CAC050187OtherMEDICAL LICENCE
CAC050187OtherMEDICAL LICENCE
CAFG2500735OtherDEA
MO0005911BMedicare PIN
CAC050187OtherMEDICAL LICENCE
MOC50525Medicare UPIN