NPIMap

Organization Active NPI

Michael D. Kotzen, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Valley Village, CA
National Provider Identifier
1013105972
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4686 Issued in CA
Legal business name
MICHAEL D. KOTZEN, INC.
Practice address
12520 Magnolia Blvd Ste 304
Valley Village, CA 91607-2355
Phone
(818) 452-9902
Fax
(818) 452-9882
NPI assigned
Oct 4, 2007
Last updated
Sep 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael David Kotzen, DPM
Title
Ceo
Phone
(818) 452-9902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X E4686 CA Primary

Addresses

Primary practice location

12520 Magnolia Blvd Ste 304
Valley Village, CA 91607-2355

Mailing address

12520 Magnolia Blvd Ste 304
Valley Village, CA 91607-2355
Phone (818) 452-9902

National Provider Directory

National Provider Directory

Locations

12520 Magnolia Blvd
Ste 304
Valley Vlg, CA 91607
Phone (818) 452-9902

Practitioners & affiliated clinicians

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 87

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1013105972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 MAGNOLIA BLVD STE 304",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072355",
            "telephone_number": "818-452-9902",
            "fax_number": "818-452-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 MAGNOLIA BLVD STE 304",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072355",
            "telephone_number": "818-452-9902",
            "fax_number": "818-452-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. KOTZEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "KOTZEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-452-9902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.