MEDICARE: DR. ESRAFIL ABEDI MD

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	A30818	CA

General Provider Information

NPI Number	:	1093794604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESRAFIL ABEDI MD

Provider Business Mailing Address
First Line	:	23961 CALLE DE LA MAGDALENA
Second Line	:	SUITE # 430
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3616
Country	:	US
Telephone Number	:	949-470-0600
Fax Number	:	949-830-1096

Provider Business Practice Location Address
First Line	:	23961 CALLE DE LA MAGDALENA
Second Line	:	SUITE # 430
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3616
Country	:	US
Telephone Number	:	949-470-0600
Fax Number	:	949-830-1096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	10/25/2010

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