Healthcare Provider Details

I. General information

NPI: 1386675049
Provider Name (Legal Business Name): ALIREZA KATOUZIAN, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 PASEO CAMARILLO
CAMARILLO CA
93010
US

IV. Provider business mailing address

1100 PASEO CAMARILLO
CAMARILLO CA
93010-6073
US

V. Phone/Fax

Practice location:
  • Phone: 805-484-8558
  • Fax: 805-484-3099
Mailing address:
  • Phone: 805-585-5201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG64500
License Number StateCA

VIII. Authorized Official

Name: DR. ALIREZA KATOUZIAN
Title or Position: OWNER
Credential: MD
Phone: 805-585-5201