Provider Demographics
NPI:1386351955
Name:MOCHAYOFF, HOWARD MOSHE
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:MOSHE
Last Name:MOCHAYOFF
Suffix:
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 1:5552 W ADAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-2542
Mailing Address - Country:US
Mailing Address - Phone:323-932-6828
Mailing Address - Fax:323-932-6001
Practice Address - Street 1:5552 W ADAMS BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-2542
Practice Address - Country:US
Practice Address - Phone:323-932-6828
Practice Address - Fax:323-932-6001
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72266152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty