Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Ezaki

Individual provider Physical Therapist · NPI 1841204484

Ethan Ezaki is a Physical Therapist in Private Practice in Los Angeles, California. Qualified in 2003, 23 years ago. Practices with Khodabakhshian Chiropractic Inc, a 5-clinician group. Licensed in California.

Years since qualifying
23
Licensed in
CA
In the registry since
2006
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Practice location Address checks out

11601 Wilshire Blvd
Los Angeles, CA 90025-0509
Phone: (310) 914-4118
Fax: (310) 914-4119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 28643 (CA)

Record details

NPI number1841204484
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 28, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Khodabakhshian Chiropractic Inc — 5 clinicians
Accepts Medicare assignment Not indicated

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