Basic Information
| Provider Information | |||||||||
| NPI: | 1821316712 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EDWARD A MORALES, MD A PROFESSIONAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5585 | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930315585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052789599 | ||||||||
| FaxNumber: | 8052781220 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 W GONZALES RD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930363336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052789599 | ||||||||
| FaxNumber: | 8052781220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2010 | ||||||||
| LastUpdateDate: | 05/17/2010 | ||||||||
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| AuthorizedOfficialLastName: | MORALES | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
| AuthorizedOfficialMiddleName: | ANDREW | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8052789599 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | G81819 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.