Provider Demographics
NPI:1922540087
Name:MOSHTAGH, ROZITA (NATUROPATHIC DOCTOR)
Entity Type:Individual
Prefix:
First Name:ROZITA
Middle Name:
Last Name:MOSHTAGH
Suffix:
Gender:F
Credentials:NATUROPATHIC DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2582 LUCIERNAGA ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5819
Mailing Address - Country:US
Mailing Address - Phone:310-365-1556
Mailing Address - Fax:
Practice Address - Street 1:4540 KEARNY VILLA RD STE 211
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1586
Practice Address - Country:US
Practice Address - Phone:310-365-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA770175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath