Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A143669 | CA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD466466 | PA |
NPI | 1013335710 |
---|---|
Provider Name | Dr. Roxana Moayer |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 20/08/2020 |