Individual
ANTONIO MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1212 HILLTOP MALL RD, STE D-112, RICHMOND, CA 94806-1910
(510) 223-9770
(510) 223-9774
Mailing address
PO BOX 127, HEALDSBURG, CA 95448-0127
(510) 928-6187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11312
CA
Other
Enumeration date
01/13/2007
Last updated
07/08/2007
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