Individual
IGOR V KOZLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21114 VANOWEN ST, CANOGA PARK, CA 91303-2821
(818) 992-7848
(818) 992-7748
Mailing address
21114 VANOWEN ST, CANOGA PARK, CA 91303-2821
(818) 992-7848
(818) 992-7748
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A86248
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A86248
PHYSICIAN LICENSE NUMBER
CA
Enumeration date
07/12/2006
Last updated
10/04/2007
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