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NPI Code Detail

MEDICARE: ADAM GREGORY MOGIL PA-C

MEDICARE: ADAM GREGORY MOGIL PA-C
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
1363A00000XPhysician AssistantPA17073CA

General Provider Information

NPI Number : 1245345933
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM GREGORY MOGIL PA-C
Provider Business Mailing Address
First Line : 5522 SEPULVEDA BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91411-3437
Country : US
Telephone Number : 818-990-5020
Fax Number : 818-990-8549
Provider Business Practice Location Address
First Line : 5522 SEPULVEDA BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91411-3437
Country : US
Telephone Number : 818-990-5020
Fax Number : 818-990-8549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 08/08/2013

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Directions to “ ADAM GREGORY MOGIL PA-C” Practice Location

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