DR. Mashallah Ezzati, M.D

NPI #1023011087 in Lake Forest, California

Provider Information

NPI Number: 1023011087
Entity Type: Individual
Name: DR. Mashallah Ezzati, M.D
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: General Practice
Credential: M.D
Enumeration Date: May 24, 2005
Last Updated: Aug 30, 2010

Practice Location

Address: 23361 EL TORO RD
Address 2: 107
City: Lake Forest
State: California
ZIP Code: 92630-6922
Phone: (949) 235-9818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary
Family Medicine - Addiction Medicine — Addiction Medicine	207QA0401X

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