Healthcare Provider Details

I. General information

NPI: 1982666483
Provider Name (Legal Business Name): ALAN KAZAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 07/08/2007
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 93156
PHOENIX AZ
85070-3156
US

V. Phone/Fax

Practice location:
  • Phone: 480-456-0285
  • Fax: 480-456-9580
Mailing address:
  • Phone: 480-456-0285
  • Fax: 480-456-9580

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:
Title or Position:
Credential:
Phone: