Individual
CAROL S MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 N VERMONT AVE, DEPT OF RADIOLOGY, LOS ANGELES, CA 90027-6005
(323) 913-4860
(323) 913-4922
Mailing address
PO BOX 657, WEST COVINA, CA 91793-0657
(909) 595-4595
(909) 595-4365
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
G67355
CA
2085N0700X
Neuroradiology Physician
G67355
CA
2085N0904X
Nuclear Radiology Physician
G67355
CA
2085P0229X
Pediatric Radiology Physician
Primary
G67355
CA
2085R0202X
Diagnostic Radiology Physician
G67355
CA
2085U0001X
Diagnostic Ultrasound Physician
G67355
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G673550
—
CA
01
—
G67355
CA MEDICAL BOARD LIC
CA
01
—
WG67355Q
PPIN
CA
Enumeration date
08/25/2006
Last updated
09/11/2025
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