Healthcare Provider Details

I. General information

NPI: 1477638468
Provider Name (Legal Business Name): DONALD I KUZYK DPM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7937 LILY TROTTER ST
NORTH LAS VEGAS NV
89084-2408
US

IV. Provider business mailing address

7937 LILY TROTTER ST
NORTH LAS VEGAS NV
89084-2408
US

V. Phone/Fax

Practice location:
  • Phone: 805-732-6310
  • Fax:
Mailing address:
  • Phone: 805-732-6310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3256
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberE3256
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberE3256
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberE3256
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberE3256
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE3256
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE3256
License Number StateCA

VIII. Authorized Official

Name: DONALD I KUZYK
Title or Position: OFFICE MANAGER
Credential:
Phone: 805-732-6310