Individual provider · Type 1 NPI
Jack Theodore Ezzedine
Medical Physician Assistant · Alhambra, CA
NPI number
1053137513
Active
Practice location
1000 S Fremont Ave
Alhambra, CA 91803-8800
Mailing address
678 E Walnut St Unit 311
Pasadena, CA 91101-2283
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
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Other medical physician assistant providers in Alhambra
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- Robbi Ann Robinson, PA-CMedical Physician Assistant Alhambra, CA NPI 1518601533
- Dick Chuang, PHYSICIAN ASSISTANTMedical Physician Assistant Alhambra, CA NPI 1588752349
- Shanqiang ZhangMedical Physician Assistant Alhambra, CA NPI 1619166626
About NPI 1053137513
Jack Theodore Ezzedine's National Provider Identifier is 1053137513, issued on Dec 2, 2024. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Alhambra, CA. The record was last updated on Dec 2, 2024.