Individual
HAYAT MOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8110 BIRMINGHAM WAY, SAN DIEGO, CA 92123-2758
(858) 966-4003
Mailing address
3020 CHILDRENS WAY, MC5003, SAN DIEGO, CA 92123-4223
(858) 309-6300
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
35065608
OH
2080P0206X
Pediatric Gastroenterology Physician
Primary
C 137969
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108724000
—
WV
05
—
0932772
—
OH
05
—
64964240
—
KY
01
—
MO0890502
MEDICARE
OH
Enumeration date
09/12/2005
Last updated
05/03/2017
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