Individual
SAMUEL MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26859 PINE HOLLOW CT, VALENCIA, CA 91381-0615
(661) 253-2231
Mailing address
26859 PINE HOLLOW CT, VALENCIA, CA 91381-0615
(661) 253-2231
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2009-0106
NM
2085R0202X
Diagnostic Radiology Physician
C36173
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C361730
BLUE SHIELD
CA
05
—
00C361730
—
CA
Enumeration date
06/06/2006
Last updated
11/02/2011
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