Provider Demographics
NPI:1598778599
Name:MOYES, DAN PHILIP (NP)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:PHILIP
Last Name:MOYES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6578
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93386-6578
Mailing Address - Country:US
Mailing Address - Phone:661-326-2263
Mailing Address - Fax:
Practice Address - Street 1:1111 COLUMBUS ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-1936
Practice Address - Country:US
Practice Address - Phone:661-326-5000
Practice Address - Fax:661-326-5005
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200137363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ17045Medicare UPIN