| Doctor Name: | DR. SAMUEL A MOGUL |
| NPI Number: | 1427050533 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | G40018 |
| Business Practice Address: | 14901 Rinaldi St Ste 200 Mission Hills, CA - 913451254 |
| Business Phone Number: | 8183658553 |
| Business Fax Number: | 8183654524 |
| Mailing Address: | 777 Flower St, Ste A GLENDALE |
| State: | CA |
| Postal Code: | 912013000 |
| Phone Number: | 8186372000 |
| Fax Number: | 8182428761 |
| NPI Enumeration Date: | 06/01/2005 |
| NPI Last Update Date: | 11/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G40018 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |