Individual
MATTIN MOAZZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(312) 942-5000
Mailing address
13031 SANDOWN WAY, SAN DIEGO, CA 92130-3740
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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