Individual
ANTONIO MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
(909) 883-8711
Mailing address
25590 PROSPECT AVE APT 25H, LOMA LINDA, CA 92354-3149
(323) 440-1388
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95001104
CA
Other
Enumeration date
04/18/2019
Last updated
01/31/2025
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