Provider Demographics
NPI:1669552212
Name:MOSSER, SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:MOSSER
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 1:450 SUTTER ST RM 1010
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-3912
Mailing Address - Country:US
Mailing Address - Phone:415-780-1515
Mailing Address - Fax:628-867-6510
Practice Address - Street 1:450 SUTTER ST RM 1010
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-3912
Practice Address - Country:US
Practice Address - Phone:415-780-1515
Practice Address - Fax:628-867-6510
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA824372086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A824370Medicare ID - Type UnspecifiedMEDICAL BILLING ACCOUNT #
CAZZZ29936ZMedicare ID - Type UnspecifiedMEDICARE GROUP #
CA100022Medicare UPIN