Provider Demographics
NPI:1497839708
Name:MOSES, MAX (MD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:MOSES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5424 SUNOL BLVD
Mailing Address - Street 2:SUITE 10-262
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7705
Mailing Address - Country:US
Mailing Address - Phone:925-862-9961
Mailing Address - Fax:877-871-1371
Practice Address - Street 1:2400 COUNTRY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5329
Practice Address - Country:US
Practice Address - Phone:925-862-9961
Practice Address - Fax:877-871-1371
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29314207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery