Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Etie Moghissi, MD, Inc

Organization Clinic/Center · NPI 1487723821

Etie Moghissi, MD, Inc is a Clinic/Center in Marina del Rey, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4644 Lincoln Blvd Ste 409
Marina del Rey, CA 90292-6390
Phone: (310) 578-6747
Fax: (310) 578-6750
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence A38025 (CA)

Record details

NPI number1487723821
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Etie Moghissi — President · (310) 578-6747
NPI enumeratedNovember 8, 2006
Last updated in NPPESFebruary 6, 2008
Mailing address4644 Lincoln Blvd Ste 409, Marina Del Rey, CA 90292-6390