Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 227133 | MA |
Y | 207X00000X | Orthopaedic Surgeon | A98833 | CA |
NPI | 1013921386 |
---|---|
Provider Name | Dr. Thomas Francis Moyad |
First Address | La Mesa, CA 91942-3083 |
Second Address | La Mesa, CA 91942-3083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 16/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BQ915A | (02) | CA |