Provider Demographics
NPI:1285675975
Name:MOSCOW, NORMAN
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:
Last Name:MOSCOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 OAK GROVE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2536
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7171
Practice Address - Street 1:2125 OAK GROVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2536
Practice Address - Country:US
Practice Address - Phone:925-296-7150
Practice Address - Fax:925-296-7171
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC313122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C3131213Medicare PIN
CA00C313120Medicare PIN
CA00C3131217Medicare PIN
CA300104412Medicare PIN
CA00C3131215Medicare PIN
CA00C3131219Medicare PIN
CA00C313123Medicare PIN
CA300034864Medicare PIN
CAA34525Medicare UPIN
CA00C3131218Medicare PIN
CA00C313125Medicare PIN
CA00C3131211Medicare PIN
CA00C313124Medicare PIN
CA00C313126Medicare PIN
CA00C3131214Medicare PIN
CA00C3131220Medicare PIN
CA00C313127Medicare PIN
CA00C313128Medicare PIN
CA00C313129Medicare PIN
CA300097017Medicare PIN
CA00C313121Medicare PIN
CA00C3131210Medicare PIN
CA00C3131216Medicare PIN
CA00C313122Medicare PIN