Provider Demographics
NPI:1528160538
Name:ROBERT E MOEBIUS MD INC
Entity type:Organization
Organization Name:ROBERT E MOEBIUS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MOEBIUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:805-482-0496
Mailing Address - Street 1:905 CALLE ACOPADA
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-8423
Mailing Address - Country:US
Mailing Address - Phone:805-482-0496
Mailing Address - Fax:805-482-8294
Practice Address - Street 1:905 CALLE ACOPADA
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8423
Practice Address - Country:US
Practice Address - Phone:805-482-0496
Practice Address - Fax:805-482-8294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC287792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8338417Medicaid
C28779Medicare ID - Type Unspecified
A87294Medicare UPIN