Healthcare Provider Details

I. General information

NPI: 1811078330
Provider Name (Legal Business Name): ALEXANDER MOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 03/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10005 FLOWER ST
BELLFLOWER CA
90706-5412
US

IV. Provider business mailing address

10005 FLOWER ST
BELLFLOWER CA
90706-5412
US

V. Phone/Fax

Practice location:
  • Phone: 562-804-8112
  • Fax: 562-867-2766
Mailing address:
  • Phone: 562-804-8112
  • Fax: 562-867-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG69992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: