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Active NPI 1023011087 Individual Practitioner Male Practitioner

Dr. Mashallah Ezzati , MD

General Practice • Lake Forest, CA

Professional Overview & Biography Verified Profile Summary

Dr. Mashallah Ezzati, MD is a registered healthcare professional specializing in General Practice in Lake Forest, CA. Practice services are available at 23361 EL TORO RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

23361 El Toro Rd
107

Lake Forest, CA 926306922

Telephone 9492359818
Fax 9493059500
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Lake Forest, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
1 Specialists

Practicing in Lake Forest, CA (2300 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License CA C42933

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Family Medicine - Addiction Medicine

NUCC Taxonomy Code: 207QA0401X

State License CA C42933

A family medicine physician who specializes in the diagnosis and treatment of addictions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Jung-Joo Kim , DC

Chiropractor - Nutrition

NPI 1700081411

Doctor of Chiropractic

Dr. James Kuechler , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1851300198

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 30, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location August 30, 2010

Registered at 23361 EL TORO RD, 107, LAKE FOREST, CA 926306922 (Tel: 9492359818)

📍
Updated Business Mailing Address August 30, 2010

Registered at 23361 EL TORO RD, 107, LAKE FOREST, CA 926306922 (Tel: 9492359818)

👤
Provider Name / Credentials Updated August 30, 2010

Recorded as MASHALLAH EZZATI, M.D

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 30, 2010

Family Medicine (License #C42933 in CA)

🟢
Initial NPI Registration & Enumeration May 24, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023011087
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2005
Last Update: August 30, 2010
Sole Proprietor: No

Mailing Address

23361 El Toro Rd, 107

Lake Forest, CA 926306922

Phone: 9492359818

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.