Individual
KENNETT J. MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1145 STURGIS ROAD, TWENTYNINE PALMS, CA 92278-8275
(608) 302-1177
Mailing address
1145 STURGIS ROAD, TWENTYNINE PALMS, CA 92278
(760) 830-2117
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01052596A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01052596A
PHYSICIAN
IN
Enumeration date
12/08/2006
Last updated
08/21/2023
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