Individual provider · Type 1 NPI
Mashallah Ezzati, MD
General Practice Physician · Lake Forest, CA
NPI number
1023011087
Active
Practice location
23361 El Toro Rd, 107
Lake Forest, CA 92630-6922
Fax (949) 305-9500
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | C42933 (CA) |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | C42933 (CA) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
3 other providers at this address
About NPI 1023011087
Mashallah Ezzati, MD's National Provider Identifier is 1023011087, issued on May 24, 2005. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Lake Forest, CA. The record was last updated on Aug 30, 2010.