Active NPI
Robert Allan Moss, M.D.
- Hematology & Oncology Physician
- Fountain Valley, CA
National Provider Identifier
1861503609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- G33764
- Practice address
- 11180 Warner Ave Ste 467
Fountain Valley, CA 92708-7505 - Phone
- (714) 641-1128
- Fax
- (714) 540-7610
- NPI assigned
- Aug 31, 2006
- Last updated
- Jan 20, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | G33764 | CA | Primary |
Addresses
Primary practice location
11180 Warner Ave Ste 467
Fountain Valley, CA 92708-7505
Mailing address
11180 Warner Ave Ste 467
Fountain Valley, CA 92708-7505
Phone (714) 641-1128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G337640 | Medicaid | CA |
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G33764 | CA | MD | Hematology & Oncology Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hematology & Oncology Physician
- Fountain Valley, CA
- NPI 1508902875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579478400000",
"number": "1861503609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11180 WARNER AVE STE 467",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927087505",
"telephone_number": "714-641-1128",
"fax_number": "714-540-7610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11180 WARNER AVE STE 467",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927087505",
"telephone_number": "714-641-1128",
"fax_number": "714-540-7610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "ROBERT",
"middle_name": "ALLAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2020-01-20",
"certification_date": "2020-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CA",
"license": "G33764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G337640",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.