Provider Demographics
NPI:1295015212
Name:MOSC, LLC
Entity Type:Organization
Organization Name:MOSC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHARRAFA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-996-4713
Mailing Address - Street 1:4611 E SHEA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-4254
Mailing Address - Country:US
Mailing Address - Phone:602-996-4713
Mailing Address - Fax:602-795-6766
Practice Address - Street 1:4611 E SHEA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4254
Practice Address - Country:US
Practice Address - Phone:602-996-4713
Practice Address - Fax:602-795-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical