=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134318363
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOSSI SALIBIAN MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2007
-----------------------------------------------------
Last Update Date | 05/02/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9201 W SUNSET BLVD SUITE 917
-----------------------------------------------------
City | WEST HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90069-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-550-0750
-----------------------------------------------------
Fax | 310-550-0760
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9201 W SUNSET BLVD SUITE 917
-----------------------------------------------------
City | WEST HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90069-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-550-0750
-----------------------------------------------------
Fax | 310-550-0760
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. MOSSI SALIBIAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 310-550-0750
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | A79293
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------