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General NPI Number Information
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NPI Number | 1982332763
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Entity Type | Organization
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Legal Business Name | MOHAMMAD ELBATTA MD, INC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 17400 IRVINE BLVD STE F
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City | TUSTIN
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State | CA
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Zip | 92780-3030
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Country | US
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Telephone | 949-806-1301
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Fax |
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Provider Business Mailing Address
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Address Line | 8583 IRVINE CENTER DR # 331
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City | IRVINE
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State | CA
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Zip | 92618-4298
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMAD ELBATTA
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Credential | MD
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Telephone | 949-806-1301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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