Healthcare Provider Details

I. General information

NPI: 1306827787
Provider Name (Legal Business Name): ALIYA FEROUZ-COLBORN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALIYA FEROUZ M.D.

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 N EL CAMINO REAL SUITE D-308
ENCINITAS CA
92024-1328
US

IV. Provider business mailing address

477 N EL CAMINO REAL SUITE D-308
ENCINITAS CA
92024-1328
US

V. Phone/Fax

Practice location:
  • Phone: 760-942-9028
  • Fax: 760-942-5055
Mailing address:
  • Phone: 760-942-9028
  • Fax: 760-942-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License NumberG84256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: