Moss, Fred R
Moss, Fred R is an sole proprietor health care provider with primary practice located at 121 Stanford Ct , Grass Valley CA 95945-5657. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Moss, Fred R can be contacted via phone (916) 671-0007.Contact Information
Primary practice address
121 Stanford Ct
Grass Valley CA 95945-5657
Phone: (916) 671-0007
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 4301097758 | Michigan |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 036129270 | Illinois |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 35059484A | Ohio |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | G89083 | California |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 01059042A | Indiana |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 201202116 | North Carolina |
Profile Details
| NPI number | 1982657235 |
|---|---|
| LBN Legal business name | Moss, Fred R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2006 |
| Last updated | Aug 22nd, 2023 - about last year |
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 | 1982657235 | NPPES |
| Indiana | MEDICAID | 200467160A | |
| Indiana | MEDICAID | 0827672 | |
| Indiana | MEDICAID | 6493173600 |
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