Moses Elam, MD | |
7373 West Ln, Stockton, CA 95210-3377 | |
(209) 476-2000 | |
Not Available |
Full Name | Moses Elam |
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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 |
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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 |
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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 |
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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 | |
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 | |
Amanzoopinder Samrao, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 7373 West Ln, Stockton, CA 95210 Phone: 209-476-2166 | |
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 |