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General NPI Number Information
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NPI Number | 1457380107
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Entity Type | Individual
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Provider Name | RICHARD JOSEPH KOZAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 27700 MEDICAL CENTER RD
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6426
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Country | US
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Telephone | 949-309-8434
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Fax |
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Provider Business Mailing Address
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Address Line | 21271 CALLE HORIZONTE
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City | LAKE FOREST
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State | CA
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Zip | 92630-2145
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Country | US
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Telephone | 949-829-9769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | G75758
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License Number State | CA
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