Provider Demographics
NPI:1841231248
Name:MOZA, KAPIL (MD)
Entity Type:Individual
Prefix:
First Name:KAPIL
Middle Name:
Last Name:MOZA
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 1:313 S MOORPARK RD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1008
Mailing Address - Country:US
Mailing Address - Phone:805-497-3636
Mailing Address - Fax:805-497-3637
Practice Address - Street 1:313 S MOORPARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1008
Practice Address - Country:US
Practice Address - Phone:805-497-3636
Practice Address - Fax:805-497-3637
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA91270207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A912700Medicaid
CAA91270Medicare PIN
CAI07248Medicare UPIN