Provider Demographics
NPI:1902241284
Name:ALAN KAZAN MD PC
Entity Type:Organization
Organization Name:ALAN KAZAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-531-5954
Mailing Address - Street 1:PO BOX 51645
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85076-1645
Mailing Address - Country:US
Mailing Address - Phone:602-531-5954
Mailing Address - Fax:602-437-6550
Practice Address - Street 1:7575 E EARLL DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6915
Practice Address - Country:US
Practice Address - Phone:480-456-0285
Practice Address - Fax:480-456-9580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ100922084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD15571Medicare UPIN