MEDICARE: DR. KAREN R. MOYES 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	G31433	CA

General Provider Information

NPI Number	:	1629292958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN R. MOYES M.D.

Provider Business Mailing Address
First Line	:	5121 DEPOT ST
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-9652
Country	:	US
Telephone Number	:	805-685-9525
Fax Number	:	805-685-5191

Provider Business Practice Location Address
First Line	:	5121 DEPOT ST
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-9652
Country	:	US
Telephone Number	:	805-685-9525
Fax Number	:	805-685-5191

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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