Individual
CHANTE ALLI MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(215) 681-7866
Mailing address
1370 ORO VISTA RD APT 150, SAN DIEGO, CA 92154-3172
(215) 681-7866
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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