| Moses Elam, MD | |
|
7373 West Ln, Stockton, CA 95210-3377 | |
| (209) 476-2000 | |
| Not Available |
| Full Name | Moses Elam |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 7373 West Ln, Stockton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023196938 | NPI | - | NPPES |
| 00G855120 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | G85512 (California) | Secondary |
| 207N00000X | Dermatology | 075586 (Georgia) | Primary |
| Entity Name | The Emory Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396798229 PECOS PAC ID: 8820901408 Enrollment ID: O20031110000503 |
| Entity Name | Emory Medical Care Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063452381 PECOS PAC ID: 4981501814 Enrollment ID: O20031217000968 |
| Mailing Address | Practice Location Address |
|---|---|
| Moses Elam, MD 1800 Harrison St Fl 7, Oakland, CA 94612-3429 Ph: (510) 625-6262 | Moses Elam, MD 7373 West Ln, Stockton, CA 95210-3377 Ph: (209) 476-2000 |
Stuart I Jacobs, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 5345 N El Dorado St, Ste 12, Stockton, CA 95207 Phone: 209-957-6662 Fax: 209-957-0310 | |
Dr. Christy Behnam, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2505 W Hammer Ln, Stockton, CA 95209 Phone: 209-955-3000 Fax: 209-954-4024 | |
Karen B. Bissell, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 7373 West Ln, Stockton, CA 95210 Phone: 209-476-2000 | |
Elizabeth M. Kass, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 7373 West Ln, Stockton, CA 95210 Phone: 209-476-2000 | |
Gerald N Bock, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1617 St Marks Plaza, C, Stockton, CA 95207 Phone: 209-956-4260 Fax: 209-475-6002 | |
Walter Stanley Yourchek, MD Dermatology Medicare: Medicare Enrolled Practice Location: 4553 Quail Lakes Dr, Stockton, CA 95207 Phone: 209-951-1133 Fax: 209-951-4708 |