Provider Demographics
NPI:1295777837
Name:MOLDOVAN, AMIR (MD)
Entity type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:MOLDOVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:23206 LYONS AVENUE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92321-2671
Mailing Address - Country:US
Mailing Address - Phone:661-505-9901
Mailing Address - Fax:661-505-9902
Practice Address - Street 1:23206 LYONS AVENUE
Practice Address - Street 2:SUITE 106
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:92321-2671
Practice Address - Country:US
Practice Address - Phone:661-505-9901
Practice Address - Fax:661-505-9902
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2020-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA104056207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGC959ZOtherMEDICARE PTAN