Individual
REBECA I MOREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 409-4277
Mailing address
10165 COOK AVE, RIVERSIDE, CA 92503-2817
(909) 552-3077
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
88169
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88169
—
CA
Enumeration date
10/20/2020
Last updated
10/20/2020
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