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NPI 1598701526

NPI 1598701526 : DAVID M MOSS MD : FOUNTAIN VALLEY, CA

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General NPI Number Information
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    NPI Number           |    1598701526
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID M MOSS MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/20/2006
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    Last Update Date     |    12/01/2021
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Provider Practice Location Address
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    Address Line         |    17100 EUCLID ST 
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    City                 |    FOUNTAIN VALLEY
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    State                |    CA
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    Zip                  |    92708-4004
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    Country              |    US
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    Telephone            |    714-966-7200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 20140 
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    City                 |    FOUNTAIN VALLEY
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    State                |    CA
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    Zip                  |    92728-0140
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    Country              |    US
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    Telephone            |    562-809-3572
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    A64283
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    License Number State |    CA
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