MEDICARE: DR. PAUL HENRY MOSER MD

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	207RG0100X	Gastroenterology Physician	C-43316	CA

General Provider Information

NPI Number	:	1497840409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL HENRY MOSER MD

Provider Business Mailing Address
First Line	:	11949 NAVAJA LN
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-8336
Country	:	US
Telephone Number	:	619-579-1684
Fax Number	:	619-662-5412

Provider Business Practice Location Address
First Line	:	4650 PALM AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-8404
Country	:	US
Telephone Number	:	619-662-5416
Fax Number	:	619-662-5412

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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