Provider Demographics
NPI:1285050815
Name:MOSLEY, LUCIUS LEE III
Entity type:Individual
Prefix:
First Name:LUCIUS
Middle Name:LEE
Last Name:MOSLEY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-2224
Mailing Address - Country:US
Mailing Address - Phone:661-326-9709
Mailing Address - Fax:661-326-9709
Practice Address - Street 1:721 8TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-2224
Practice Address - Country:US
Practice Address - Phone:661-326-9700
Practice Address - Fax:661-326-9709
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator