Organization
WEST COAST ORTHOPAEDIC MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY M. MOSCARELLO M.D. (PHYSICIAN/PRESIDENT)
(626) 821-0707
Entity
Organization
Contact information
Practice address
301 W HUNTINGTON DR, SUITE 408, ARCADIA, CA 91007-3462
(626) 821-0707
(626) 821-0239
Mailing address
301 W HUNTINGTON DR, SUITE 408, ARCADIA, CA 91007-3462
(626) 821-0707
(626) 821-0239
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568453967
—
CA
01
—
ZZZ577232
BLUE SHIELD
—
Enumeration date
11/03/2005
Last updated
05/13/2009
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