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Individual
DR. KOZUR IRENE VAZAGOV
Active
Individual
DR. KOZUR IRENE VAZAGOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10433T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54220SD0104330
BLUE SHIELD
CA
01
—
954509552
BLUE CROSS
CA
Enumeration date
10/26/2006
Last updated
01/31/2011
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