Basic Information
| Provider Information | |||||||||
| NPI: | 1467528778 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORITZ | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 31309 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900310309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234428541 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1812 VERDUGO BLVD | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912081407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187907100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 10/19/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | G032766 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0904X | G032766 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085P0229X | G032766 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology | 2085R0001X | G032766 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0203X | G032766 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology | 2085U0001X | G032766 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | 2085R0202X | G32766 | CA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.