Provider Demographics
NPI:1184627721
Name:MOSKOW, LONNIE J (MD)
Entity type:Individual
Prefix:DR
First Name:LONNIE
Middle Name:J
Last Name:MOSKOW
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24331 EL TORO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3116
Mailing Address - Country:US
Mailing Address - Phone:949-586-3200
Mailing Address - Fax:949-900-2136
Practice Address - Street 1:24331 EL TORO RD STE 200
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3116
Practice Address - Country:US
Practice Address - Phone:949-586-3200
Practice Address - Fax:949-900-2136
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65811174400000X, 207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARR2000 19526OtherMEDICARE RAILROAD
CA00G658110G89OtherCAL OPTIMA
CA00G658110Medicaid
CAWG65811IMedicare ID - Type Unspecified