Organization
MD & ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LEE MOFFIT (NATIONAL BIILING MANAGER)
(909) 476-7679
Entity
Organization
Contact information
Practice address
14189 FOOTHILL BLVD, 107B, FONTANA, CA 92335-3093
(909) 476-7679
(951) 572-3745
Mailing address
14189 FOOTHILL BLVD, SUITE 107B, FONTANA, CA 92335-3093
(909) 476-7679
(909) 476-0777
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D08604467
EDI SUBMITTER ID
CA
Enumeration date
08/28/2007
Last updated
06/27/2011
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