Moadab, Anoosh
Moadab, Anoosh is an sole proprietor health care provider with primary practice located at 6115 N 1St St Ste 101 , Fresno CA 93710-5450. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Moadab, Anoosh can be contacted via phone (559) 436-1213.Contact Information
Primary practice address
6115 N 1St St Ste 101
Fresno CA 93710-5450
Phone: (559) 436-1213
Fax: (559) 436-4202
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | E4514 | California |
Profile Details
NPI number | 1912904376 |
---|---|
LBN Legal business name | Moadab, Anoosh |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 30th, 2005 |
Last updated | Apr 20th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1912904376 | NPPES |
California | Other | 00E45140 | BLUE SHIELD |
California | Other | 611685600 | BLUE SHIELD |
California | Other | E45140 | BLUE SHIELD |
California | MEDICAID | 000E45140 | BLUE SHIELD |
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