Organization
MICHAEL W. MOATS, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W. MOATS M.D. (PRESIDENT)
(805) 922-3632
Entity
Organization
Contact information
Practice address
525 PLAZA DR, SUITE 200, SANTA MARIA, CA 93454-6953
(805) 922-3632
(805) 922-3522
Mailing address
525 PLAZA DR, SUITE 200, SANTA MARIA, CA 93454-6953
(805) 922-3632
(805) 922-3522
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2889069
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1064504
CLIA NUMBER
CA
01
—
CLM334547
CLIA REGISTRATION NUMBER- STATE OF CA
CA
Enumeration date
08/31/2006
Last updated
03/17/2009
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