Mark R. Ezekiel, M.D., a Medical Corporation

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

G72866 Issued in CA

Legal business name

MARK R. EZEKIEL, M.D., A MEDICAL CORPORATION

Practice address

5750 Downey Ave
Suite 306
Lakewood, CA 90712-1405

Phone

(310) 362-3162

NPI assigned

Sep 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark R Ezekiel, M.D.

Title

President

Phone

(310) 362-3162

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1255528857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 N SEPULVEDA BLVD",
            "address_2": "#320",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662725",
            "telephone_number": "310-362-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 DOWNEY AVE",
            "address_2": "SUITE 306",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121405",
            "telephone_number": "310-362-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R. EZEKIEL, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "EZEKIEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-362-3162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G72866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.