Individual
RODRICK WAYNE MOORE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4060 WHITTIER BLVD, LOS ANGELES, CA 90023-2526
(323) 268-5514
Mailing address
1605 MENDOCINO WAY, PERRIS, CA 92571-3732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95001146
CA
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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