Healthcare Provider Details

I. General information

NPI: 1275811317
Provider Name (Legal Business Name): LLOYD MICHAEL CUZZO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 12/03/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 DE SOTO AVE KAISER PERMANENTE
WOODLAND HILLS CA
91367-6701
US

IV. Provider business mailing address

5601 DE SOTO AVE KAISER PERMANENTE
WOODLAND HILLS CA
91367-6701
US

V. Phone/Fax

Practice location:
  • Phone: 855-892-0919
  • Fax: 818-719-2201
Mailing address:
  • Phone: 855-892-0919
  • Fax: 818-719-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA123453
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: