# DR. JORGE LUIS MORENO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1306118393
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | 20A6911 | CA | — |
| 172M00000X | Mechanotherapist | 20A6911 | CA | — |
| 175L00000X | Homeopath | 20A6911 | CA | — |
| 204R00000X | Electrodiagnostic Medicine Physician | 20A6911 | CA | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 20A6911 | CA | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | 20A6911 | CA | — |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | 20A6911 | CA | — |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | 20A6911 | CA | — |
| 208D00000X | General Practice Physician | 20A6911 | CA | Yes |

## Other

- **Enumeration date:** 02/06/2012
- **Last updated:** 07/18/2019