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General NPI Number Information
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NPI Number | 1275570756
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Entity Type | Organization
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Legal Business Name | MOATAZ GIURGIUS M D INC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 20409 YORBA LINDA BLVD SUITE K2-265
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City | YORBA LINDA
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State | CA
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Zip | 92886-3042
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Country | US
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Telephone | 562-947-8832
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Fax | 562-947-8839
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Provider Business Mailing Address
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Address Line | 20409 YORBA LINDA BLVD STE K2-265
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City | YORBA LINDA
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State | CA
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Zip | 92886-3042
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Country | US
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Telephone | 562-947-8832
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Fax | 562-947-8839
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SHADEE GIURGIUS
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Credential | M.D.
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Telephone | 562-947-8832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A53359
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License Number State | CA
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