Individual
JESSICA NICHOLE MOSELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 SAN PABLO ST, LOS ANGELES, CA 90033-5313
(323) 442-8541
(323) 442-8755
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-8541
(323) 442-8755
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A136800
CA
208600000X
Surgery Physician
ML60370491
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ML60370491
MEDICAL LICENSE
WA
Enumeration date
04/15/2013
Last updated
11/29/2021
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