Individual
ROBERT A KOLANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G55707
CA
2085R0204X
Vascular & Interventional Radiology Physician
G55707
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G557070
BLUE SHIELD
CA
05
—
00G557070
—
CA
Enumeration date
11/19/2005
Last updated
04/25/2013
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