Provider Demographics
NPI:1740573120
Name:ESMAILZADEGAN, ARASH (MD)
Entity type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:ESMAILZADEGAN
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 1:17822 BEACH BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7172
Mailing Address - Country:US
Mailing Address - Phone:714-375-1122
Mailing Address - Fax:949-863-8581
Practice Address - Street 1:17822 BEACH BLVD STE 300
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7172
Practice Address - Country:US
Practice Address - Phone:714-375-1122
Practice Address - Fax:949-863-8581
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136449207LP2900X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA800322775Medicaid