| Masood Moghaddam | |
|
5975 Entrada Ave Atascadero CA 93422-4223 | |
| (805) 703-3540 | |
| (805) 466-9765 |
| Full Name | Masood Moghaddam |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5975 Entrada Ave, Atascadero, California |
| Authorized Official Name and Position | Masood Moghaddam (OWNER) |
| Authorized Official Contact | 8057033540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Masood Moghaddam 5975 Entrada Ave Atascadero CA 93422-4223 Ph: (805) 703-3540 | Masood Moghaddam 5975 Entrada Ave Atascadero CA 93422-4223 Ph: (805) 703-3540 |
| NPI Number | 1114553344 |
|---|---|
| Provider Enumeration Date | 03/19/2020 |
| Last Update Date | 03/19/2020 |
| Certification Date | 03/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114553344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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