Individual
JOSE ANTONIO MOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
760 E 9TH ST SPC 25, SAN BERNARDINO, CA 92410-4053
(909) 521-4268
Mailing address
760 E 9TH ST SPC 25, SAN BERNARDINO, CA 92410-4053
(909) 521-4268
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E170039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20060100714400
—
CA
Enumeration date
11/11/2022
Last updated
11/11/2022
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