Individual
MR. LUIS ROBERTO MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
5807 AVALON BLVD, LOS ANGELES, CA 90011-5303
(323) 233-2452
Mailing address
10207 SAN ANSELMO AVE, SOUTH GATE, CA 90280-5624
(323) 360-4050
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86003373
CA
Other
Enumeration date
08/11/2015
Last updated
07/10/2020
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