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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
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