Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | C50303 | CA |
NPI | 1205912847 |
---|---|
Provider Name | Dr. Elias N Moukarzel |
First Address | El Centro, CA 92243-4368 |
Second Address | El Centro, CA 92243-3685 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 02/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C503030 | (05) | CA |
C503030 | (02) | CA |
F76436 | (02) | CA |
W13536 | GROUP PTAN (01) | CA |