MEDICARE: DR. ERIC MOSIER D.O

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1154682649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC MOSIER D.O

Provider Business Mailing Address
First Line	:	4050 3RD AVE
Second Line	:	APT 309
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 3RD AVE
Second Line	:	APT 309
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2139
Country	:	US
Telephone Number	:	419-349-4035
Fax Number	:

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

Provider Enumeration Date	:	05/31/2012
Last Update Date	:	11/04/2021

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