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Individual
WESLEY S MOORE
Active
Individual
WESLEY S MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A19266
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A19266
BLUE SHIELD
CA
01
—
A19266
BLUE CROSS
CA
01
—
P00168682
MEDICARE PIN
CA
Enumeration date
07/26/2006
Last updated
12/20/2019
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