Individual
TZE K IP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26800 CROWN VALLEY PKWY STE 120, MISSION VIEJO, CA 92691-8033
(949) 364-3388
(949) 364-5026
Mailing address
26800 CROWN VALLEY PKWY STE 120, MISSION VIEJO, CA 92691-8033
(949) 364-3388
(949) 364-5026
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G84213
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G842130
—
CA
Enumeration date
12/23/2005
Last updated
10/28/2020
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