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General NPI Number Information
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NPI Number | 1568591493
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Entity Type | Organization
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Legal Business Name | VAN SCOY-MOSHER MILLER MDS
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST 600 E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-659-9397
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Fax | 310-854-3028
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Provider Business Mailing Address
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Address Line | 8631 W 3RD ST 600 E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-659-9397
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Fax | 310-854-3028
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Authorized Official
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Title or Position | PARTNER
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Name | MICHAEL B VAN SCOY-MOSHER
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Credential | MD
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Telephone | 310-659-9397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | G22248
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License Number State | CA
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