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Individual
ALAN FOZAILOFF
Active
Individual
ALAN FOZAILOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A76164
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A761640
BLUE SHILELD
CA
05
—
00A761640
—
CA
01
—
A76164
LICENSE
CA
Enumeration date
07/20/2006
Last updated
01/10/2017
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