Provider Demographics
NPI:1295177608
Name:KAZAN, DAVID LOUIS (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LOUIS
Last Name:KAZAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 15TH ST
Mailing Address - Street 2:PO BOX 529
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-4203
Mailing Address - Country:US
Mailing Address - Phone:714-417-7000
Mailing Address - Fax:206-666-1773
Practice Address - Street 1:401 15TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-4203
Practice Address - Country:US
Practice Address - Phone:714-417-7000
Practice Address - Fax:206-666-1773
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41976207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology