Provider Demographics
NPI:1679544779
Name:ASHKENAZE, DAVID MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:ASHKENAZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31862 COAST HWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6769
Mailing Address - Country:US
Mailing Address - Phone:949-499-8226
Mailing Address - Fax:949-499-2430
Practice Address - Street 1:31862 COAST HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6769
Practice Address - Country:US
Practice Address - Phone:949-499-8226
Practice Address - Fax:949-499-2430
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65521207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA58552Medicare UPIN