Organization
CHARLES J MORAN MD INC
Active
Organization
CHARLES J MORAN MD INC
Active
Other names
Paso Robles Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J. MORAN MD (OWNER)
(805) 226-0902
Entity
Organization
Contact information
Practice address
1763 RAMADA DRIVE, PASO ROBLES, CA 93446
(805) 226-0902
(805) 226-0905
Mailing address
1763 RAMADA DRIVE, PASO ROBLES, CA 93446
(805) 226-0902
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
C3076452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0245163
WASHINGTON STATE DOL
CA
01
—
05D1091562
CLIA #
CA
01
—
614136900
USDOL
CA
01
—
C3076452
CALIF STATE LICENSE
CA
01
—
ZZZ54744Y
BLUE SHIELD GRP PIN
CA
Enumeration date
05/30/2008
Last updated
10/21/2009
Update your record
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