Healthcare Provider Details

I. General information

NPI: 1518736743
Provider Name (Legal Business Name): ELIZABETH ALLEN MOSER-CHANG NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD STE 403
PASADENA CA
91101-2018
US

IV. Provider business mailing address

PO BOX 1632
MONROVIA CA
91017-5632
US

V. Phone/Fax

Practice location:
  • Phone: 626-775-7121
  • Fax:
Mailing address:
  • Phone: 323-552-8446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: