Mai Moiseshyn, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17051 Issued in CA

Practice address

12665 Garden Grove Blvd
#502-A
Garden Grove, CA 92843-1901

Phone

(714) 537-7800

Fax

(714) 537-7633

NPI assigned

Jun 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mai Nguyen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1437194693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD",
            "address_2": "STE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043737",
            "telephone_number": "714-826-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "#502-A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-537-7800",
            "fax_number": "714-537-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOISESHYN",
        "first_name": "MAI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAI",
            "last_name": "NGUYEN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Viridiana Mojica, B.A.
• Alyssa Molina
• Liseth Carolina Molina
• Mireya Molina
• Julie Mominee, MA, BCBA

• Physician Assistant in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.