MEDICARE: ERIC MIZRAHI MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC29526	CA
2	207R00000X	Internal Medicine Physician	G85225	CA

General Provider Information

NPI Number	:	1043488257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC MIZRAHI MD INC

Provider Business Mailing Address
First Line	:	11911 SAN VINCENTE BLVD
Second Line	:	#225
City	:	LOS ANGELES
State	:	CA
Zip	:	90049
Country	:	US
Telephone Number	:	310-471-7714
Fax Number	:	310-471-7781

Provider Business Practice Location Address
First Line	:	11911 SAN VICENTE BLVD
Second Line	:	SUITE 225
City	:	LOS ANGELES
State	:	CA
Zip	:	90049
Country	:	US
Telephone Number	:	310-471-7714
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ERIC MIZRAHI
Credential	:	MD
Telephone Number	:	310-471-7714

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	05/04/2026

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