Healthcare Provider Details

I. General information

NPI: 1679544779
Provider Name (Legal Business Name): DAVID MICHAEL ASHKENAZE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31862 COAST HWY SUITE 400
LAGUNA BEACH CA
92651-6769
US

IV. Provider business mailing address

31862 COAST HWY SUITE 400
LAGUNA BEACH CA
92651-6769
US

V. Phone/Fax

Practice location:
  • Phone: 949-499-8226
  • Fax: 949-499-2430
Mailing address:
  • Phone: 949-499-8226
  • Fax: 949-499-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberG65521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: