Individual
EHSAN EJAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
130 LA CASA VIA # 2-210, WALNUT CREEK, CA 94598-3045
(925) 309-5155
(925) 623-5156
Mailing address
130 LA CASA VIA STE 210, WALNUT CREEK, CA 94598-3035
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
56621
CA
Other
Enumeration date
06/05/2014
Last updated
01/03/2025
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