Individual
TISHA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 303-6204
Mailing address
FILE 2939, LOS ANGELES, CA 90074-2939
(310) 301-8709
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
PA16773
CA
363AS0400X
Surgical Physician Assistant
PA16773
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PA167730
MEDI CAL
CA
Enumeration date
07/18/2006
Last updated
08/27/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us