Provider Demographics
NPI:1851592778
Name:MOOSA, FERZAAD (MD)
Entity Type:Individual
Prefix:
First Name:FERZAAD
Middle Name:
Last Name:MOOSA
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 1:16542 VENTURA BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-5045
Mailing Address - Country:US
Mailing Address - Phone:818-907-8606
Mailing Address - Fax:
Practice Address - Street 1:16130 VENTURA BLVD.
Practice Address - Street 2:SUITE # 120
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2552
Practice Address - Country:US
Practice Address - Phone:818-907-8606
Practice Address - Fax:818-379-9786
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60007207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology