Provider Demographics
NPI:1750655395
Name:MOYES, DONALD ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ROBERT
Last Name:MOYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:143 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-2130
Mailing Address - Country:US
Mailing Address - Phone:626-286-6752
Mailing Address - Fax:626-286-5256
Practice Address - Street 1:143 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-2130
Practice Address - Country:US
Practice Address - Phone:626-286-6752
Practice Address - Fax:626-286-5256
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAFE18603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine