MEDICARE: DR. CHARLES A MOSER PH.D., M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G75487	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	110129325	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001CA04167	OTHER	CA	TRICARE
2	00G754870	OTHER	CA	BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083615983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES A MOSER PH.D., M.D.

Provider Business Mailing Address
First Line	:	325 DISTEL CIR
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1408
Country	:	US
Telephone Number	:	415-600-4900
Fax Number	:	415-369-1365

Provider Business Practice Location Address
First Line	:	45 CASTRO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-1010
Country	:	US
Telephone Number	:	415-600-4900
Fax Number	:	415-369-1365

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	08/28/2020

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Directions to “ DR. CHARLES A MOSER PH.D., M.D.” Practice Location

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