Provider Demographics
NPI:1184624769
Name:HOLZMAN, MADELYN (MD)
Entity type:Individual
Prefix:DR
First Name:MADELYN
Middle Name:
Last Name:HOLZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 RIO LINDO AVE
Mailing Address - Street 2:SUITE 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:SUITE 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
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0459208800000X
CAC53106208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1184624769Medicaid
CAP00762607OtherMEDICARE RAILROAD #
CAP00762607OtherMEDICARE RAILROAD #
TXF26644Medicare UPIN