Provider Demographics
NPI:1760170005
Name:MOZ, HECTOR FERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:FERNANDO
Last Name:MOZ
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 1:14585 ARIZONA ST
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0807
Mailing Address - Country:US
Mailing Address - Phone:909-697-6651
Mailing Address - Fax:
Practice Address - Street 1:14585 ARIZONA ST
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-0807
Practice Address - Country:US
Practice Address - Phone:909-697-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty