Etie Moghissi (NPI# 1003007576, PAC ID# 5799864146) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ENDOCRINOLOGY.
| Nation Provider ID (NPI) | 1003007576 |
| PAC ID by PECOS | 5799864146 |
| Professional Enrollment ID | I20080509000379 |
| Full Name | Etie Moghissi |
| Organization Legal Name | PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION |
| Address |
12555 W Jefferson Blvd Suite 302 Los Angeles CA 90066-7032 |
| Phone Number | 3106701455 |
| Gender | F |
| Graduation Year | 1977 |
| Primary Specialty | ENDOCRINOLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 0840548624 |
| Number of Group Practice Members | 141 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 12555 W Jefferson Blvd, Suite 302, Los Angeles, CA 90066-7032 | 3106701455 | PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION |
| Organization Legal Name | PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION |
| Physicians | 200 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa Chialin Liu | Internal Medicine | Providence Saint Johns Medical Foundation | 12121 Santa Monica Blvd, Los Angeles, CA 90025-2515 |
| Asad Julian Bedran | Family Medicine | Providence Saint Johns Medical Foundation | 8570 W Sunset Blvd, West Hollywood, CA 90069-2359 |
| Matthew K Nienaber | Internal Medicine | Providence Saint Johns Medical Foundation | 1821 Wilshire Blvd, Suite 100, Santa Monica, CA 90403-5627 |
| Jennifer P Carleton-nathan | Family Medicine | Providence Saint Johns Medical Foundation | 700 S Flower St, Suite 2340, Los Angeles, CA 90017-4123 |
| Meghan Moore | Physician Assistant | Providence Saint Johns Medical Foundation | 525 Broadway, Suite 1101, Santa Monica, CA 90401-2971 |
| Michelle Grotz-rhone | Internal Medicine | Providence Saint Johns Medical Foundation | 9725 Wilshire Blvd, Beverly Hills, CA 90212-2002 |
| Mina Kang | Internal Medicine | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Carol Nishikubo | Hematology/oncology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Los Angeles, CA 90066-7032 |
| Howard Ronald Krauss | Ophthalmology | Providence Saint Johns Medical Foundation | 2125 Arizona Ave, Santa Monica, CA 90404-1337 |
| Richard L Ross | Family Medicine | Providence Saint Johns Medical Foundation | 901 Wilshire Blvd, Fl 3, Santa Monica, CA 90401-1854 |
| Street Address |
12555 W JEFFERSON BLVD SUITE 302 |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066-7032 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carol Nishikubo | Hematology/oncology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Los Angeles, CA 90066-7032 |
| Dale G Parks | Obstetrics/gynecology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Suite 301, Los Angeles, CA 90066-7032 |
| Jordan C Kawano | Internal Medicine | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Suite 303, Los Angeles, CA 90066-7032 |
| Gabriel S Niles | Family Medicine | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Suite 301, Los Angeles, CA 90066-7032 |
| Jade Singer | Physician Assistant | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Los Angeles, CA 90066-7032 |
| Mojan Gabbay | Obstetrics/gynecology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Suite 301, Los Angeles, CA 90066-7032 |
| Dorothy Patrice Harris | Neurology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Suite 303, Los Angeles, CA 90066-7032 |
| Stanley A Hubbard | Family Medicine | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Los Angeles, CA 90066-7032 |
| Laurie A Kane | Endocrinology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Los Angeles, CA 90066-7032 |
| Mia Di Julio | Obstetrics/gynecology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Los Angeles, CA 90066-7032 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sylvia G Jones | Clinical Social Worker | 3301 Colby Ave, Los Angeles, CA 90066-1325 | |
| Brian Huth | Chiropractic | Health Atlast West La | 3030 Sawtelle Blvd, Los Angeles, CA 90066-1408 |
| Wayne Higashi | Chiropractic | Health Atlast West La | 3030 Sawtelle Blvd, Los Angeles, CA 90066-1408 |
| Vishal Thakral | Physical Medicine and Rehabilitation | Health Atlast West La | 3030 Sawtelle Blvd, Los Angeles, CA 90066-1408 |
| Stephanie Christine Higashi | Chiropractic | Health Atlast West La | 3030 Sawtelle Blvd, Los Angeles, CA 90066-1408 |
| Richard Ochs | General Practice | Health Atlast West La | 3030 Sawtelle Blvd, Los Angeles, CA 90066-1408 |
| Mohamed Hassanin | Chiropractic | Health Atlast West La | 3030 Sawtelle Blvd, Los Angeles, CA 90066-1408 |
| Martha J Joachim | Psychologist, Clinical | 12549 Woodbine St, Los Angeles, CA 90066-1830 | |
| Jane Meryl Emmer | Psychologist, Clinical | 3413 Craigview Ave, Los Angeles, CA 90066-2110 | |
| Susan F Horn | Clinical Social Worker | 3492 Ashwood Ave, Los Angeles, CA 90066-2202 | |
| Find all physicians in zip 90066 | |||
| City | LOS ANGELES |
| Zip Code | 90066 |
| Specialty | ENDOCRINOLOGY |
| City + Specialty | LOS ANGELES + ENDOCRINOLOGY |
Please comment or provide details below to improve the information on Etie Moghissi.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.