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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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