Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3256 | CA |
Y | 222Z00000X | Podiatrist | E3256 | CA |
N | 213EP0504X | Public Medicine | E3256 | CA |
N | 213EP1101X | Primary Podiatric Medicine | E3256 | CA |
N | 111NR0200X | Radiology | E3256 | CA |
N | 213ER0200X | Radiology | E3256 | CA |
N | 2081S0010X | Sports Medicine | E3256 | CA |
N | 213ES0000X | Sports Medicine | E3256 | CA |
N | 213ES0103X | Foot & Ankle Surgery | E3256 | CA |
N | 213ES0131X | Foot Surgery | E3256 | CA |
NPI | 1205899689 |
---|---|
Provider Name | Donald I Kuzyk |
First Address | Simi Valley, CA 93065-1208 |
Second Address | Simi Valley, CA 93065-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 23/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E32560 | (05) | CA |
000E32561 | (05) | CA |
T19293 | (02) | CA |