Fozailoff, Alan

Fozailoff, Alan is an individual health care provider with primary practice located at 18370 Burbank Blvd Suite 211, Tarzana CA 91356-2804. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Fozailoff, Alan can be contacted via phone (818) 334-5750.

Contact Information

Primary practice address
18370 Burbank Blvd Suite 211 Tarzana CA 91356-2804
Phone: (818) 334-5750
Fax: (951) 272-9924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A76164 California

Profile Details

NPI number 1053331595
LBN Legal business name Fozailoff, Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jan 10th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053331595 NPPES
California Other 00A761640 BLUE SHILELD
California MEDICAID 00A761640 BLUE SHILELD
California Other A76164 BLUE SHILELD

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