Individual
CHARLES ALLEN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8950 VILLA LA JOLLA DRIVE, A217, LA JOLLAA, CA 92037-1711
(858) 457-1314
(858) 457-3615
Mailing address
8950 VILLA LA JOLLA DRIVE, A217, LA JOLLAA, CA 92037-1711
(858) 457-1314
(858) 457-3615
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G033632
CA
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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