Provider Demographics
NPI:1548281108
Name:MAIZEL, HAROLD (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:MAIZEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W STEWART DR
Mailing Address - Street 2:SUITE #407
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3854
Mailing Address - Country:US
Mailing Address - Phone:714-288-8987
Mailing Address - Fax:714-538-6672
Practice Address - Street 1:1310 W STEWART DR
Practice Address - Street 2:SUITE #407
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3854
Practice Address - Country:US
Practice Address - Phone:714-288-8987
Practice Address - Fax:714-538-6672
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG8370207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G83700Medicaid
B58177Medicare UPIN
CAG8370Medicare ID - Type Unspecified