Provider Demographics
NPI:1821496357
Name:MOESCHLER, DAVID M (RN, PHN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:MOESCHLER
Suffix:
Gender:M
Credentials:RN, PHN
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 408
Mailing Address - Street 2:
Mailing Address - City:BURNEY
Mailing Address - State:CA
Mailing Address - Zip Code:96013-0408
Mailing Address - Country:US
Mailing Address - Phone:530-335-6705
Mailing Address - Fax:530-335-6706
Practice Address - Street 1:36911 STATE HIGHWAY 299 E
Practice Address - Street 2:
Practice Address - City:BURNEY
Practice Address - State:CA
Practice Address - Zip Code:96013-4050
Practice Address - Country:US
Practice Address - Phone:530-335-6705
Practice Address - Fax:530-335-6706
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 524452251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare