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General NPI Number Information
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NPI Number | 1891106076
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Entity Type | Individual
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Provider Name | ANTONIO MOYA MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 05/09/2014
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | 1100 GLENDON AVE STE 900
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City | LOS ANGELES
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State | CA
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Zip | 90024-3513
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Country | US
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Telephone | 310-794-2268
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 GLENDON AVE STE 900
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City | LOS ANGELES
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State | CA
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Zip | 90024-3513
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Country | US
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Telephone |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A155525
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License Number State | CA
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