Provider Demographics
NPI:1386780633
Name:SALIBIAN, MOSSI (MD INC)
Entity type:Individual
Prefix:DR
First Name:MOSSI
Middle Name:
Last Name:SALIBIAN
Suffix:
Gender:M
Credentials:MD INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:SUITE 917
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3701
Mailing Address - Country:US
Mailing Address - Phone:310-550-0750
Mailing Address - Fax:310-550-0760
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:SUITE 917
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-550-0750
Practice Address - Fax:310-550-0760
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79293208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH46766Medicare UPIN