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NPI Code Detail

MEDICARE: DR. WANJIKU ANN MAXINE MOITE M.D.

MEDICARE:  DR. WANJIKU ANN MAXINE MOITE  M.D.
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
1207Q00000XFamily Medicine PhysicianA70738CA

General Provider Information

NPI Number : 1194726984
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WANJIKU ANN MAXINE MOITE M.D.
Provider Business Mailing Address
First Line : 1172 N MACLAY AVE
Second Line :
City : SAN FERNANDO
State : CA
Zip : 91340-1328
Country : US
Telephone Number : 818-898-1388
Fax Number : 818-365-4031
Provider Business Practice Location Address
First Line : 7843 LANKERSHIM BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-2523
Country : US
Telephone Number : 818-765-8656
Fax Number : 818-765-6982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 07/08/2007

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Directions to “ DR. WANJIKU ANN MAXINE MOITE M.D.” Practice Location

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