Active NPI
Alexander Fabien Mooza, M.D.
- Psychiatry Physician
- Las Vegas, NV
National Provider Identifier
1558566315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LL1654
- Practice address
- 2810 W Charleston Blvd
Suite 78
Las Vegas, NV 89102-1921 - Phone
- (702) 870-3415
- NPI assigned
- Jun 20, 2007
- Last updated
- Jun 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LL1654 | NV | Primary |
Addresses
Primary practice location
2810 W Charleston Blvd
Suite 78
Las Vegas, NV 89102-1921
Mailing address
2810 W Charleston Blvd
Suite 78
Las Vegas, NV 89102-1921
Phone (702) 870-3415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL1654 | NV | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1558566315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2810 W CHARLESTON BLVD",
"address_2": "SUITE 78",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891021921",
"telephone_number": "702-870-3415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 W CHARLESTON BLVD",
"address_2": "SUITE 78",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891021921",
"telephone_number": "702-870-3415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOZA",
"first_name": "ALEXANDER",
"middle_name": "FABIEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-20",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NV",
"license": "LL1654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.