Basic Information
| Provider Information | |||||||||
| NPI: | 1063506863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELFAIZY | ||||||||
| FirstName: | MEHDAT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 HOLLAND | ||||||||
| Address2: | STE. 101 | ||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926182566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495882190 | ||||||||
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| Practice Location | |||||||||
| Address1: | 24022 CALLE DE LA PLATA STE 180 | ||||||||
| Address2: | |||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926533627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9494583551 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A25642 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.