Individual
ALEXEI IVANOVICH POUZAKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 459-3770
(559) 459-3719
Mailing address
4910 E CLINTON WAY, SUITE 101, FRESNO, CA 93727-1560
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA21289
CA
363AS0400X
Surgical Physician Assistant
Primary
PA21289
CA
Other
Enumeration date
02/09/2011
Last updated
07/10/2012
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