Provider Demographics
NPI:1043447436
Name:MADELYN HOLZMAN MD MC
Entity Type:Organization
Organization Name:MADELYN HOLZMAN MD MC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MADELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-893-1127
Mailing Address - Street 1:572 RIO LINDO AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1851
Mailing Address - Country:US
Mailing Address - Phone:530-893-1127
Mailing Address - Fax:530-893-1128
Practice Address - Street 1:572 RIO LINDO AVE
Practice Address - Street 2:STE 201
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1851
Practice Address - Country:US
Practice Address - Phone:530-893-1127
Practice Address - Fax:530-893-1128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53106208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1043447436Medicaid
CADP5009OtherMEDICARE RAILROAD #
CA1043447436Medicaid