MEDICARE: MICHAEL MOSSAD DO

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	207Q00000X	Family Medicine Physician	20A24347	CA

General Provider Information

NPI Number	:	1235871427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MOSSAD DO

Provider Business Mailing Address
First Line	:	2822 E FLORENCE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5749
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2822 E FLORENCE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5749
Country	:	US
Telephone Number	:	323-923-1900
Fax Number	:

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

Provider Enumeration Date	:	04/08/2022
Last Update Date	:	01/14/2026

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