Individual
ALAN FOZAILOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18370 BURBANK BLVD, SUITE 211, TARZANA, CA 91356-2804
(818) 334-5750
(951) 272-9924
Mailing address
PO BOX 77790, CORONA, CA 92877-0126
(951) 278-5590
(951) 272-9924
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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