Provider Demographics
NPI:1730358714
Name:SCOTT W. MOSSER, MD APMC
Entity type:Organization
Organization Name:SCOTT W. MOSSER, MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOSSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-398-7778
Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4206
Mailing Address - Country:US
Mailing Address - Phone:415-398-7778
Mailing Address - Fax:415-398-7784
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4206
Practice Address - Country:US
Practice Address - Phone:415-398-7778
Practice Address - Fax:415-398-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA824372086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1669552212OtherINDIVIDUAL NPI OF OWNER