DR. MASHALLAH EZZATI M.D NPI 1023011087

NPI Information

NPI: 1023011087
Provider Name: DR. MASHALLAH EZZATI, M.D
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
23361 EL TORO RD
107
LAKE FOREST, CA
ZIP 92630
Phone: (949) 235-9818
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DR. Mashallah Ezzati, M.D is a general practice in Lake Forest, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Mashallah Ezzati, M.D NPI is 1023011087. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

23361 EL TORO RD
107
LAKE FOREST, CA
ZIP 92630-922
Phone: (949) 235-9818
Fax: (949) 305-9500

The enumeration date for this NPI number is 5/24/2005 and was last updated on 8/30/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	C42933	CALIFORNIA	No
2	208D00000X	General Practice		C42933	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D88167	MEDICARE UPIN	MASSACHUSETTS
2	J02945	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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