MEDICARE: MOATAZ GIURGIUS M D INC

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	2084P0800X	Psychiatry Physician	A53359	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275570756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOATAZ GIURGIUS M D INC

Provider Business Mailing Address
First Line	:	20409 YORBA LINDA BLVD STE K2-265
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3042
Country	:	US
Telephone Number	:	562-947-8832
Fax Number	:	562-947-8839

Provider Business Practice Location Address
First Line	:	20409 YORBA LINDA BLVD SUITE K2-265
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3042
Country	:	US
Telephone Number	:	562-947-8832
Fax Number	:	562-947-8839

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SHADEE GIURGIUS
Credential	:	M.D.
Telephone Number	:	562-947-8832

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/02/2024

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Directions to “MOATAZ GIURGIUS M D INC ” Practice Location

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