Doctor Name: | MARAT KAZAK |
NPI Number: | 1154618122 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | RESIDENT |
Business Practice Address: | 6600 Mercy Ct #150 Fair Oaks, CA - 956283158 |
Business Phone Number: | 9164594398 |
Business Fax Number: | |
Mailing Address: | 6600 Mercy Ct, 150 FAIR OAKS |
State: | CA |
Postal Code: | 956283158 |
Phone Number: | 9164594398 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2011 |
NPI Last Update Date: | 12/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | RESIDENT |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |