MEDICARE: DR. KATERINA MOAWAD DDS

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	122300000X	Dentist	49938	CA

General Provider Information

NPI Number	:	1689908923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATERINA MOAWAD DDS

Provider Business Mailing Address
First Line	:	4242 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4430
Country	:	US
Telephone Number	:	213-384-8400
Fax Number	:	213-384-8484

Provider Business Practice Location Address
First Line	:	4242 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4430
Country	:	US
Telephone Number	:	213-384-8400
Fax Number	:	213-384-8484

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

Provider Enumeration Date	:	09/18/2009
Last Update Date	:	09/18/2009

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Directions to “ DR. KATERINA MOAWAD DDS” Practice Location

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