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General NPI Number Information
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NPI Number | 1528249232
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Entity Type | Organization
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Legal Business Name | MICHAEL KAZAK MD INC
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 1040 W MAIN ST
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City | SANTA MARIA
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State | CA
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Zip | 93458-4238
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Country | US
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Telephone | 805-922-8269
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Fax | 805-349-9509
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Provider Business Mailing Address
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Address Line | 1040 W MAIN ST
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City | SANTA MARIA
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State | CA
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Zip | 93458-4238
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Country | US
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Telephone | 805-922-8269
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Fax | 805-349-9509
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL K KAZAK
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Credential | M.D.
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Telephone | 805-922-8269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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