Provider Demographics
NPI:1306827787
Name:FEROUZ-COLBORN, ALIYA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIYA
Middle Name:
Last Name:FEROUZ-COLBORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALIYA
Other - Middle Name:
Other - Last Name:FEROUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:477 N EL CAMINO REAL
Mailing Address - Street 2:SUITE D-308
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-942-9028
Mailing Address - Fax:760-942-5055
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:SUITE D-308
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-942-9028
Practice Address - Fax:760-942-5055
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84256207YS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32791Medicare UPIN