MEDICARE: DRX ONE HEALTH SERVICES, P.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
1	302R00000X	Health Maintenance Organization	G53062	CA

General Provider Information

NPI Number	:	1518276906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRX ONE HEALTH SERVICES, P.C.

Provider Business Mailing Address
First Line	:	12417 FAIR OAKS BLVD
Second Line	:	#600
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-2501
Country	:	US
Telephone Number	:	916-503-2224
Fax Number	:	270-738-7550

Provider Business Practice Location Address
First Line	:	12417 FAIR OAKS BLVD
Second Line	:	#600
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-2501
Country	:	US
Telephone Number	:	916-503-2224
Fax Number	:	270-738-7550

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY MOY
Credential	:	MD
Telephone Number	:	916-806-9778

Provider Enumeration Date	:	10/02/2010
Last Update Date	:	10/02/2010

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