Organization
ROY H. MOFFATT, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY H MOFFATT M.D. (PRESIDENT)
(818) 502-2321
Entity
Organization
Contact information
Practice address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-2321
(818) 409-7708
Mailing address
PO BOX 2311, CHATSWORTH, CA 91313-2311
(818) 718-9500
(818) 718-9507
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089570
—
CA
Enumeration date
09/09/2005
Last updated
02/19/2008
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