| Organization Name: | MICHAEL D. KOTZEN, DPM, INC. |
| NPI Number: | 1013105972 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL DAVID KOTZEN (CEO/PRESIDENT) |
| Mailing Address: | 15243 Vanowen St Suite 411b Van Nuys |
| State: | CA US |
| Postal Code: | 914053605 |
| Phone Number: | 8187823338 |
| Fax Number: | 8187823337 |
| NPI Enumeration Date: | 10/04/2007 |
| NPI Last Update Date: | 10/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E4686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |