Individual
MR. MANUEL A MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
1855 1ST AVE, 200-B, SAN DIEGO, CA 92101-2685
(619) 233-4044
(619) 233-4144
Mailing address
PO BOX 232410, 200-B, SAN DIEGO, CA 92193-2410
(858) 249-6749
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
695565
CA
Other
Enumeration date
02/09/2016
Last updated
12/09/2016
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