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1710170253 NPI number — MAZIAR LALEZARY MD

NPI Number: 1710170253
Health Care Provider/Practitioner: MAZIAR LALEZARY MD

Information about “1710170253” NPI (MAZIAR LALEZARY MD) exists in 1710170253 in HTML format HTML  |  1710170253 in plain Text format TXT  |  1710170253 in PDF (Portable Document Format) PDF  |  1710170253 in an XML format XML  formats.

NPI Number : 1710170253 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710170253",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LALEZARY",
    "FirstName": "MAZIAR",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8383 WILSHIRE BLVD",
    "SecondLineMailingAddress": "SUITE 440",
    "MailingAddressCityName": "BEVERLY HILLS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90211-2425",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-571-5026",
    "MailingAddressFaxNumber": "844-373-8462",
    "FirstLinePracticeLocationAddress": "8383 WILSHIRE BLVD STE 440",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BEVERLY HILLS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90211-2436",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-571-5026",
    "PracticeLocationAddressFaxNumber": "844-373-8462",
    "EnumerationDate": "08/18/2007",
    "LastUpdateDate": "07/18/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207WX0107X",
        "TaxonomyName": "Retina Specialist (Ophthalmology) Physician",
        "LicenseNumber": "A120462",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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