| Katayoun Moini, PA | |
|
2040 E Mariposa Ave, El Segundo, CA 90245-5027 | |
| (213) 266-5600 | |
| (213) 477-2344 |
| Full Name | Katayoun Moini |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 2040 E Mariposa Ave, El Segundo, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770581423 | NPI | - | NPPES |
| PA51495 | Other | CA | CA LICENSE |
| Entity Name | Immuno-oncology Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215463799 PECOS PAC ID: 0244509057 Enrollment ID: O20170711002269 |
| Mailing Address | Practice Location Address |
|---|---|
| Katayoun Moini, PA 2040 E Mariposa Ave, El Segundo, CA 90245-5027 Ph: (213) 266-5600 | Katayoun Moini, PA 2040 E Mariposa Ave, El Segundo, CA 90245-5027 Ph: (213) 266-5600 |
Mr. Timothy Dawayne Barmore, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 390 N Sepulveda Blvd, 1000, El Segundo, CA 90245 Phone: 310-343-6030 Fax: 310-640-9690 |
Melody Castellon, Physician Assistant Medicare: Medicare Enrolled Practice Location: 2110 E El Segundo Blvd, El Segundo, CA 90245 Phone: 310-784-3740 |
Cheyenne Patel, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 483 N Aviation Blvd, El Segundo, CA 90245 Phone: 310-653-2873 |
Elizabeth Idrogo, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 483 N Aviation Blvd Bldg 210, El Segundo, CA 90245 Phone: 310-653-6717 Fax: 310-653-6453 |
Lauren Rae Bennett, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 713 N Douglas St, El Segundo, CA 90245 Phone: 310-906-2788 Fax: 310-906-2786 |
Mr. Joseph Andrew Burrow I, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 483 N Aviation Blvd Bldg 210, El Segundo, CA 90245 Phone: 310-653-2890 |
Duke Romeo Salvador, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 483 N Aviation Blvd, El Segundo, CA 90245 Phone: 310-653-2873 |