Provider Demographics
NPI:1013921386
Name:MOYAD, THOMAS FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:MOYAD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5565 GROSSMONT CENTER DRIVE
Mailing Address - Street 2:BLDG 3, SUITE 156
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3083
Mailing Address - Country:US
Mailing Address - Phone:619-462-0900
Mailing Address - Fax:619-462-3584
Practice Address - Street 1:5565 GROSSMONT CENTER DRIVE
Practice Address - Street 2:BLDG 3, SUITE 156
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3083
Practice Address - Country:US
Practice Address - Phone:619-462-0900
Practice Address - Fax:619-462-3584
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2009-10-16
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Provider Licenses
StateLicense IDTaxonomies
MA227133207X00000X
CAA98833207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABQ915AMedicare UPIN