Organization
SANTA MONICA SPORTS MEDICINE INC.
Active
Organization
SANTA MONICA SPORTS MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORGE MORAN M.D. (PRESIDENT)
(310) 458-1259
Entity
Organization
Contact information
Practice address
900 WILSHIRE BLVD. #410, SANTA MONICA, CA 90401
(310) 458-1259
(310) 458-1395
Mailing address
900 WILSHIRE BLVD STE 410, SANTA MONICA, CA 90401-1886
(310) 458-1259
(310) 458-1395
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A63662
CA
Other
Enumeration date
03/10/2014
Last updated
03/10/2014
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