Individual
DANIEL MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1902 RIVERSIDE ST, KINGSBURG, CA 93631-2054
(559) 836-0040
Mailing address
1902 RIVERSIDE ST, KINGSBURG, CA 93631-2054
(559) 836-0040
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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