Individual
ROY H MOFFATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 W COVINA BLVD, SAN DIMAS, CA 91773-3245
(909) 599-6811
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
C39148
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C391480
—
CA
Enumeration date
09/08/2005
Last updated
02/19/2008
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