Individual
MATTHEW S KOZLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
838 NORDAHL ROAD, SUITE 270, SAN MARCOS, CA 92069-3596
(760) 489-5955
(760) 489-7150
Mailing address
2067 WINERIDGE PLACE, SUITE A, ESCONDIDO, CA 92029-1952
(760) 489-5955
(760) 489-7150
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
40482
KY
208600000X
Surgery Physician
Primary
C55616
CA
208600000X
Surgery Physician
ME108087
FL
2086S0102X
Surgical Critical Care Physician
40482
KY
2086S0127X
Trauma Surgery Physician
40482
KY
2086S0127X
Trauma Surgery Physician
MD12565
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200869360
—
IN
01
—
50016289
PASSPORT
KY
05
—
7100005600
—
KY
Enumeration date
02/01/2007
Last updated
12/07/2017
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