Individual
DR. MICHAEL WILLIAM MOATS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
525 E PLAZA DR, SUITE #200, SANTA MARIA, CA 93454-6953
(805) 922-3632
(805) 922-3522
Mailing address
2285 CORPORATE CIR STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G30085
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G300850
BLUE SHIELD OF CALIFORNIA
CA
05
—
00G300850
—
CA
Enumeration date
01/17/2006
Last updated
05/09/2018
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