Moffatt, Roy H

Moffatt, Roy H is an individual health care provider with primary practice located at 1350 W Covina Blvd , San Dimas CA 91773-3245. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Moffatt, Roy H can be contacted via phone (909) 599-6811.

Contact Information

Primary practice address
1350 W Covina Blvd San Dimas CA 91773-3245
Phone: (909) 599-6811
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X C39148 California

Profile Details

NPI number 1386638054
LBN Legal business name Moffatt, Roy H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Feb 19th, 2008 - about 18 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 1386638054 NPPES
California MEDICAID 00C391480

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