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Organization
ST MARY SPECIALTY CLINIC
Active
Organization
ST MARY SPECIALTY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSES T MUKAI JR. M.D. (PRESIDENT)
(714) 449-4800
Entity
Organization
Contact information
Practice address
19333 BEAR VALLEY RD STE 106, APPLE VALLEY, CA 92308-5149
(760) 240-5505
(760) 240-5525
Mailing address
DEPT LA 21190, PASADENA, CA 91185-1190
(714) 449-4800
(714) 449-4956
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
09/21/2010
Last updated
05/31/2013
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