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Organization
TIMOTHY R. MORENO, MD, INC
Active
Organization
TIMOTHY R. MORENO, MD, INC
Active
Other names
Moreno Urology
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY R MORENO M.D. (PRESIDENT)
(209) 840-2575
Entity
Organization
Contact information
Practice address
105 S FOREST RD, SONORA, CA 95370-4895
(209) 532-1255
(209) 532-8436
Mailing address
105 S FOREST RD, SONORA, CA 95370-4895
(209) 532-1255
(209) 532-8436
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A45369
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A453690
—
CA
Enumeration date
03/06/2017
Last updated
03/06/2017
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