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Individual

DR. ILAN BAZAK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1121 N FAIRFOX AVE, LOS ANGELES, CA 90046
(323) 650-6363
(323) 650-4377
Mailing address
1121 N FAIRFOX AVE, LOS ANGELES, CA 90046
(323) 650-6363
(323) 650-4377

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3741
CA

Other

Enumeration date
05/22/2006
Last updated
07/08/2007
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