MR. TERRY LEE MOFFIT (NPI# 1407498942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407498942 |
Entity Type | Individual |
Full Name | MR. TERRY LEE MOFFIT |
Practice Address |
1165 W 15th St San Bernardino CA 92411-1811 |
Practice Telephone | 9095216876 |
Practice Fax Number | 9094951782 |
Mailing Telephone | 9095216876 |
Mailing Fax Number | 9094951782 |
Enumeration Date | 2019-10-16 |
Last Update Date | 2019-10-16 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171W00000X | Contractor | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 1679524391 | 05 |
Street Address |
1165 W 15TH ST |
City | SAN BERNARDINO |
State | CA |
Zip Code | 92411-1811 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619537016 | Shaunice Renee Cox | Case Manager/Care Coordinator | 1604 Pennsylvania Street, San Bernardino, CA 92411 | 2019-06-18 |
1104327543 | Wilson Gomer M.d. Professional Medical Corporation | Clinic/Center | 1800 Western Ave Ste 103, San Bernardino, CA 92411 | 2018-02-21 |
1467883504 | Pedro Lynn Hayes | Nurse Practitioner | 1800 Medical Center Dr. #99, San Bernardono, CA 92411 | 2013-11-27 |
1184973505 | Maria G Villasenor Perez | Social Worker | 1002 W 7th St, San Bernardino, CA 92411 | 2012-08-30 |
1003140948 | Joe Mawad | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411 | 2009-09-24 |
1124255146 | Angie Bagheri Cook | Pediatrics | 565 N. Mount Vernon Ave, San Bernardino, CA 92411 | 2009-06-17 |
1770637365 | Paul Anthony Tenette | Pharmacist | Delta Drugs, 1666 N Medical Center Drive, San Bernadino, CA 92411 | 2007-01-22 |
1225117328 | Vinod Kumar Kaura | Internal Medicine | 1800 N Western Ave #303, San Bernardino, CA 92411 | 2006-11-02 |
1861582314 | Cecilia Talpa Quinones | Physician Assistant | 565 N. Mount Vernon Ave., San Bernardino, CA 92411 | 2006-10-13 |
1710075247 | Bramara Arya | Pediatrics | 1505 W. 17th Street, San Bernardino, CA 92411 | 2006-10-10 |
Find all providers in zip 92411 |
Taxonomy Code | 171W00000X |
Grouping | Other Service Providers |
Classification | Contractor |
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427232248 | Vikki Lynn Rutledge | Contractor | 2316 Valencia Ave, San Bernardino, CA 92404-4034 | 2007-12-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194324012 | Bailey Rose Medical Billing LLC | Contractor | 839 Fan Palm Ln, Brentwood, CA 94513-5680 | 2020-10-21 |
1245837566 | Irshad H Fardan | Contractor | 2167 Pasetta Dr Apt 1, Santa Clara, CA 95050-3249 | 2020-10-09 |
1245838531 | Karen Strickland | Contractor | 3450 Sacramento St # 531, San Francisco, CA 94118-1914 | 2020-10-09 |
1831796879 | Laura Barker | Contractor | 55 River Oaks Pl Apt 381, San Jose, CA 95134-2074 | 2020-10-02 |
1477167054 | Jarib Takezhi Concilco Colin | Contractor | 3862 Sherwood Pl, Sherman Oaks, CA 91423-4608 | 2020-09-01 |
1609492289 | Neil Sankar | Contractor | 3610 Flora Vista Ave Apt 238, Santa Clara, CA 95051-3508 | 2020-06-19 |
1467077404 | Eric Avirett | Contractor | 1944 Bonita Ave, Berkeley, CA 94704-1038 | 2020-06-16 |
1699305805 | Sanjiv Ramdeo | Contractor | 710 Santa Susana St, Sunnyvale, CA 94085-3470 | 2020-01-16 |
1538701693 | Ramin P Shirazi IIi | Contractor | 25411 Mina Ct, Lake Forest, CA 92630-5311 | 2019-10-10 |
1689215204 | Jacinto Verges IIi | Contractor | 2117 Bluebird St, San Diego, CA 92114-1502 | 2019-10-04 |
Find all providers with the same taxonomy |
City | SAN BERNARDINO |
Zip Code | 92411 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.