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General NPI Number Information
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NPI Number | 1760909345
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Entity Type | Individual
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Provider Name | SUSAN F. MOEIN D.C.
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Gender | Female
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 1833 SEABREEZE ST
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City | THOUSAND OAKS
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State | CA
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Zip | 91320-6542
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Country | US
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Telephone | 818-426-2287
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Fax | 818-426-2287
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Provider Business Mailing Address
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Address Line | 1833 SEABREEZE ST
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City | THOUSAND OAKS
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State | CA
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Zip | 91320-6542
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Country | US
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Telephone | 818-426-2287
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Fax | 818-426-2287
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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 | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 20061
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License Number State | CA
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