Healthcare Provider Details

I. General information

NPI: 1376808626
Provider Name (Legal Business Name): DAVID MOADDEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7230 MEDICAL CENTER DR STE 100
WEST HILLS CA
91307-4001
US

IV. Provider business mailing address

7230 MEDICAL CENTER DR STE 100
WEST HILLS CA
91307-4001
US

V. Phone/Fax

Practice location:
  • Phone: 818-697-4488
  • Fax: 818-697-6526
Mailing address:
  • Phone: 310-666-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberC174179
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC174179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: