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ESHAGH EZRA M.D. NPI 1790797835


NPI Information

NPI: 1790797835
Provider Name: ESHAGH EZRA, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 05D1042925

Address:
15424 NORDHOFF ST
SUITE B
NORTH HILLS, CA
ZIP 91343
Phone: (818) 891-5500
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Eshagh Ezra, M.D. is a family medicine in North Hills, CA with 46 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Eshagh Ezra, M.D. NPI is 1790797835. 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:

15424 NORDHOFF ST
SUITE B
NORTH HILLS, CA
ZIP 91343-951
Phone: (818) 891-5500
Fax: (818) 891-5505

The NPI 1790797835 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D1042925 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/13/2006 and was last updated on 2/8/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineA56249CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G65304MEDICARE UPINCALIFORNIA
200A562490MEDICAIDCALIFORNIA
3W18753MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE GROUP #
4WA56249GMEDICARE PINCALIFORNIA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.