MEDICARE: MOATAZ K GIURGIUS 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	2084P0800X	Psychiatry Physician	A53359	CA

General Provider Information

NPI Number	:	1548217573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOATAZ K GIURGIUS MD

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	09/08/2023

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