Elam, Moses

Elam, Moses is an individual health care provider with primary practice located at 7373 West Ln , Stockton CA 95210-3377. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Elam, Moses can be contacted via phone (209) 476-2000.

Contact Information

Primary practice address
7373 West Ln Stockton CA 95210-3377
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G85512 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 075586 Georgia

Profile Details

NPI number 1023196938
LBN Legal business name Elam, Moses
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Nov 27th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023196938 NPPES
California MEDICAID 00G855120

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