Alan Fozailoff
Nephrologist
18370 Burbank Blvd Suite 211
Tarzana
, California 91356-2804
Alan Fozailoff
Nephrologist
18370 Burbank Blvd Suite 211
Tarzana
, California 91356-2804
(951) 272-9924
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Alan Fozailoff
- Po Box 77790
- Corona, CA
- Zip : 92877-0126
- Fax : (951) 272-9924
- Phone : (951) 278-5590
Second Address
- Alan Fozailoff
- 18370 Burbank Blvd Suite 211
- Tarzana, CA
- Zip : 91356-2804
- Fax : (951) 272-9924
- Phone : (818) 334-5750
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | A76164 | CA |
National Provider Identifier
| NPI | 1053331595 |
|---|---|
| Provider Name | Alan Fozailoff |
| First Address | Corona, CA 92877-0126 |
| Second Address | Tarzana, CA 91356-2804 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/07/2006 |
| Last Update Date | 10/01/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00A761640 | (05) | CA |
| 00A761640 | BLUE SHILELD (01) | CA |
| A76164 | LICENSE (01) | CA |
| H15088 | (02) | |
| H15088 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.