Healthcare Provider Details

I. General information

NPI: 1154165561
Provider Name (Legal Business Name): STACY JULIA MOROZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 07/13/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 GILMAN DR
LA JOLLA CA
92093-1009
US

IV. Provider business mailing address

4235 PORTE DE PALMAS UNIT 179
SAN DIEGO CA
92122-5123
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-5297
  • Fax:
Mailing address:
  • Phone: 949-981-9432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number203608
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR-13290
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: