Provider Demographics
NPI:1134318363
Name:MOSSI SALIBIAN MD INC
Entity Type:Organization
Organization Name:MOSSI SALIBIAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSSI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-550-0750
Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:SUITE 917
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3701
Mailing Address - Country:US
Mailing Address - Phone:310-550-0750
Mailing Address - Fax:310-550-0760
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:SUITE 917
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-550-0750
Practice Address - Fax:310-550-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79293208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH46766Medicare UPIN