Eshagh Ezra M.D., Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A56249 Issued in CA

Legal business name

ESHAGH EZRA M.D., INC.

Practice address

15424 Nordhoff St
Suite B
North Hills, CA 91343-6951

Phone

(818) 891-5500

Fax

(818) 891-5505

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Eshagh Ezra, M.D.NPI 1790797835

Title

Owner

Phone

(818) 891-5500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eshagh Ezra, M.D.

  • Family Medicine Physician
  • North Hills, CA
  • NPI 1790797835
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770698607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22716 PAUL REVERE DR",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913024812",
            "telephone_number": "818-891-5500",
            "fax_number": "818-891-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15424 NORDHOFF ST",
            "address_2": "SUITE B",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913436951",
            "telephone_number": "818-891-5500",
            "fax_number": "818-891-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESHAGH EZRA M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EZRA",
        "authorized_official_first_name": "ESHAGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-891-5500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A56249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. EZRA'S PERSONAL NPI",
            "identifier": "1790797835",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander John Erickson, PH.D.
• Arto H Ersan, DDS
• Bianca Janet Escobedo
• Jeff Andres Escuadro, RN, NP
• Julia Diane Esfandi, DDS
• Carolyn Espejo
• Geysell Juniet Estrada
• Oscar Armando Estrada, NURSE PRACTITIONER
• Grant Etnyre, M.D.
• Jerome Kennedy Evans Jr.

• Family Medicine Physician in North Hills, CA
• Providers in North Hills, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.