# MARK R. EZEKIEL, M.D., A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255528857
- **Authorized official:** DR. MARK R EZEKIEL M.D. (PRESIDENT)
- **Authorized official phone:** (310) 362-3162

## Contact information

- **Practice address:** 5750 DOWNEY AVE, SUITE 306, LAKEWOOD, CA 90712-1405
- **Practice address phone:** (310) 362-3162
- **Mailing address:** 2711 N SEPULVEDA BLVD, \#320, MANHATTAN BEACH, CA 90266-2725
- **Mailing address phone:** (310) 362-3162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | G72866 | CA | Yes |

## Other

- **Enumeration date:** 09/27/2007
- **Last updated:** 06/09/2009