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General NPI Number Information
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NPI Number | 1801933288
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Entity Type | Individual
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Provider Name | MATTHEW S KOZLOFF M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 838 NORDAHL ROAD SUITE 270
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City | SAN MARCOS
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State | CA
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Zip | 92069-3596
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Country | US
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Telephone | 760-489-5955
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Fax | 760-489-7150
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Provider Business Mailing Address
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Address Line | 2067 WINERIDGE PLACE SUITE A
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City | ESCONDIDO
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State | CA
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Zip | 92029-1952
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Country | US
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Telephone | 760-489-5955
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Fax | 760-489-7150
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C55616
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME108087
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 40482
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 40482
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | MD12565
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License Number State | RI
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Taxonomy #6
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 40482
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License Number State | KY
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