| Doctor Name: | GEORGE J MOUSSALLY |
| NPI Number: | 1013261973 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSN,ACNP-BC,CCRN |
| License Number: | 95001181 |
| Business Practice Address: | 400 W Mineral King Ave Visalia, CA - 932916237 |
| Business Phone Number: | 5596242000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 728, VISALIA |
| State: | CA |
| Postal Code: | 932790728 |
| Phone Number: | 6023165944 |
| Fax Number: | |
| NPI Enumeration Date: | 10/30/2012 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 95001181 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |