Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | G56492 | CA |
NPI | 1285858043 |
---|---|
Provider Name | Ronald E Moser |
First Address | San Juan Capistrano, CA 92675-1561 |
Second Address | San Juan Capistrano, CA 92675-1561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |