Individual
HENRY MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2550 E FOOTHILL BLVD, PASADENA, CA 91107-3406
(626) 463-1021
(626) 396-0162
Mailing address
2550 E FOOTHILL BLVD, PASADENA, CA 91107-3406
(626) 463-1021
(626) 396-0162
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456
—
CA
Enumeration date
11/27/2017
Last updated
11/27/2017
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