Individual
AHMAD REZA ELLINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 W LA VETA AVE, SUITE 575, ORANGE, CA 92868-4300
(714) 547-0900
(714) 547-2080
Mailing address
1010 W LA VETA AVE, SUITE 575, ORANGE, CA 92868-4300
(714) 547-0900
(714) 547-2080
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
A122753
CA
2080P0202X
Pediatric Cardiology Physician
D71188
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410880901
—
MD
Enumeration date
10/05/2006
Last updated
01/22/2013
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