Individual
IANCARLO MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2222 BROADWAY ST, SAN FRANCISCO, CA 94115-1240
(209) 829-8071
Mailing address
1045 BONTA AVE, GUSTINE, CA 95322-1723
(209) 829-8071
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
04/12/2018
Last updated
08/01/2024
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