Doctor Name: | CHARLES B MOSHER |
NPI Number: | 1801950126 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G20790 |
Business Practice Address: | 5300 Hwy 49 N Mariposa, CA - 953380155 |
Business Phone Number: | 2099663672 |
Business Fax Number: | 2099665548 |
Mailing Address: | Po Box 155, MARIPOSA |
State: | CA |
Postal Code: | 953380155 |
Phone Number: | 2099663672 |
Fax Number: | 2099665548 |
NPI Enumeration Date: | 12/21/2006 |
NPI Last Update Date: | 11/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G20790 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |