Provider Demographics
NPI:1366510489
Name:MOSKOWITZ, MICHAEL HARVEY (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HARVEY
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:431 COUNTYVIEW DRIVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941
Mailing Address - Country:US
Mailing Address - Phone:415-380-0480
Mailing Address - Fax:
Practice Address - Street 1:3 HARBOR DR
Practice Address - Street 2:SUITE 115
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965-1454
Practice Address - Country:US
Practice Address - Phone:415-380-0480
Practice Address - Fax:415-380-8788
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2021-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC384062084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA36919Medicare UPIN
CA00C392260Medicare ID - Type Unspecified