Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A129081 | CA |
NPI | 1003182395 |
---|---|
Provider Name | William James Moss |
First Address | Acton, MA 01718-1009 |
Second Address | San Diego, CA 92103-9000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2012 |
Last Update Date | 03/09/2015 |