Dr Mashallah Ezzati, MD is a
General Practice physician based in Lake Forest, California. Dr Mashallah Ezzati is licensed to practice in California (license number C42933) and his current practice location is 23361 El Toro Rd, 107, Lake Forest, California. He can be reached at his office (for appointments etc.) via phone at
(949) 235-9818.
NPI number for Dr Mashallah Ezzati is 1023011087 and his current mailing address is 23361 El Toro Rd, 107, Lake Forest, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023011087.
Physician's Profile
| Full Name | Dr Mashallah Ezzati |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 23361 El Toro Rd, Lake Forest, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1023011087
- Provider Enumeration Date: 05/24/2005
- Last Update Date: 08/30/2010
Medical Identifiers
Medical identifiers for Dr Mashallah Ezzati such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023011087 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | C42933 (California) | Primary |
| 207QA0401X | Family Medicine - Addiction Medicine | C42933 (California) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mashallah Ezzati is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mashallah Ezzati, MD
23361 El Toro Rd, 107,
Lake Forest, CA 92630-6922
Ph: (949) 235-9818 | Dr Mashallah Ezzati, MD
23361 El Toro Rd, 107,
Lake Forest, CA 92630-6922
Ph: (949) 235-9818 |
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