Individual
DR. ANDREA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-3330
Mailing address
271 W SANTA CLARA DR, MOUNTAIN HOUSE, CA 95391-1292
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A155255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A155255
LICENSE NUMBER
CA
Enumeration date
04/27/2014
Last updated
12/17/2021
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