Organization
G. FAZILAT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GOLAREH FAZILAT MD (OWNER/PHYSICIAN)
(949) 502-3333
Entity
Organization
Contact information
Practice address
23832 ROCKFIELD BLVD STE 150, LAKE FOREST, CA 92630-2820
(949) 502-3333
(949) 229-3685
Mailing address
23832 ROCKFIELD BLVD STE 150, LAKE FOREST, CA 92630-2820
(949) 502-3333
(949) 229-3685
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A101403
CA
Other
Enumeration date
09/23/2010
Last updated
02/21/2018
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