| Moe Amadpour Md Inc | |
|
1159 Roadrunner Way Simi Valley CA 93065-3159 | |
| (805) 583-2643 | |
| (805) 583-0125 |
| Full Name | Moe Amadpour Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1159 Roadrunner Way, Simi Valley, California |
| Authorized Official Name and Position | Moe Amadpour (PRESIDENT) |
| Authorized Official Contact | 8055832643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moe Amadpour Md Inc Po Box 800817 Santa Clarita CA 91380-0817 Ph: (661) 430-0940 | Moe Amadpour Md Inc 1159 Roadrunner Way Simi Valley CA 93065-3159 Ph: (805) 583-2643 |
| NPI Number | 1417056391 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 06/21/2018 |
| Medicare PECOS PAC ID | 3678754009 |
|---|---|
| Medicare Enrollment ID | O20110218000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417056391 | NPI | - | NPPES |
| G81182 | Other | CA | PRESIDENT'S MCARE ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G81182 (California) | Primary |
| Provider Name | Moe Amadpour |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508965476 PECOS PAC ID: 5395735104 Enrollment ID: I20040513001559 |
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