Provider Demographics
NPI:1962482083
Name:SALIBIAN, MOSES (MD)
Entity Type:Individual
Prefix:MR
First Name:MOSES
Middle Name:
Last Name:SALIBIAN
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 1:10646 W STALLION RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SHADOW HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1385
Mailing Address - Country:US
Mailing Address - Phone:818-292-2333
Mailing Address - Fax:
Practice Address - Street 1:574 PALM DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2827
Practice Address - Country:US
Practice Address - Phone:818-292-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75971207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A75971Medicaid
CA00A75971Medicaid
CA00A75971Medicare ID - Type Unspecified