MEDICARE: DR. FELCAR PHIL MORADA M.D.

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	207Q00000X	Family Medicine Physician	A36020	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	W18496	OTHER	CA	MEDICARE PTAN

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
2	ZZZ66291Z	OTHER	CA	BLUE SHIELD CA
4	P00342643	OTHER	CA	RAILROAD MC

General Provider Information

NPI Number	:	1619919180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELCAR PHIL MORADA M.D.

Provider Business Mailing Address
First Line	:	7709 FOOTHILL BLVD
Second Line	:
City	:	TUJUNGA
State	:	CA
Zip	:	91042-2120
Country	:	US
Telephone Number	:	818-352-3146
Fax Number	:	818-352-8116

Provider Business Practice Location Address
First Line	:	7709 FOOTHILL BLVD
Second Line	:
City	:	TUJUNGA
State	:	CA
Zip	:	91042-2120
Country	:	US
Telephone Number	:	818-352-3146
Fax Number	:	818-352-8116

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	10/10/2007

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Directions to “ DR. FELCAR PHIL MORADA M.D.” Practice Location

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