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NPI Code Detail

MEDICARE: MISS AREZU MOSHIRIAN M.S.,CCC-SLP

MEDICARE: MISS AREZU MOSHIRIAN M.S.,CCC-SLP
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
1235Z00000XSpeech-Language Pathologist14341CA

General Provider Information

NPI Number : 1306942701
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS AREZU MOSHIRIAN M.S.,CCC-SLP
Provider Business Mailing Address
First Line : 13216 WIMBERLY SQ
Second Line : 180
City : SAN DIEGO
State : CA
Zip : 92128-4088
Country : US
Telephone Number : 650-504-5183
Fax Number :
Provider Business Practice Location Address
First Line : 11665 AVENA PL
Second Line : 106
City : SAN DIEGO
State : CA
Zip : 92128-2421
Country : US
Telephone Number : 858-673-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 07/08/2007

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