Provider Demographics
NPI:1841542271
Name:WILLIAM D. MOSIER MD
Entity type:Organization
Organization Name:WILLIAM D. MOSIER MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-871-2570
Mailing Address - Street 1:265 LAGUNA RD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2515
Mailing Address - Country:US
Mailing Address - Phone:714-871-2570
Mailing Address - Fax:714-441-2020
Practice Address - Street 1:265 LAGUNA RD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2515
Practice Address - Country:US
Practice Address - Phone:714-871-2570
Practice Address - Fax:714-441-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41428332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABS771ZMedicare UPIN
CAA85628Medicare UPIN
CABC450Medicare UPIN