Healthcare Provider Details

I. General information

NPI: 1902241284
Provider Name (Legal Business Name): ALAN KAZAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 E EARLL DR
SCOTTSDALE AZ
85251-6915
US

IV. Provider business mailing address

PO BOX 51645
PHOENIX AZ
85076-1645
US

V. Phone/Fax

Practice location:
  • Phone: 480-456-0285
  • Fax: 480-456-9580
Mailing address:
  • Phone: 602-531-5954
  • Fax: 602-437-6550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number10092
License Number StateAZ

VIII. Authorized Official

Name: DR. ALAN KAZAN
Title or Position: PRESIDENT
Credential: MD
Phone: 602-531-5954