Provider Demographics
NPI:1063553378
Name:MOSIER, WILLIAM D (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:MOSIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 LAGUNA RD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2515
Mailing Address - Country:US
Mailing Address - Phone:714-871-2570
Mailing Address - Fax:714-441-2020
Practice Address - Street 1:265 LAGUNA RD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2515
Practice Address - Country:US
Practice Address - Phone:714-871-2570
Practice Address - Fax:714-441-2020
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41428207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A414280Medicaid
CAP00665890OtherRAIL ROAD MEDICARE
CA00A414280Medicaid
CAA85628Medicare UPIN
CAAY754Medicare PIN