Individual
IRVING FITZGERALD MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6762 LEXINGTON AVE, LOS ANGELES, CA 90038-1217
(323) 380-7590
Mailing address
6762 LEXINGTON AVE, LOS ANGELES, CA 90038-1217
(323) 380-7590
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
CA
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
03/13/2023
Last updated
06/19/2023
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