Organization
ALAN FOZAILOFF MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN FOZAILOFF MD (PRESIDENT)
(818) 334-5750
Entity
Organization
Contact information
Practice address
18370 BURBANK BLVD, SUITE 211, TARZANA, CA 91356-2804
(800) 626-2468
Mailing address
PO BOX 77790, CORONA, CA 92877-0126
(800) 626-2468
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A76164
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A761640
BLUE SHIELD
CA
05
—
00A761640
—
CA
Enumeration date
09/20/2007
Last updated
08/30/2016
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