Individual
DR. KYLE ANTHONY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1313 CUTTING BLVD, RICHMOND, CA 94804-2554
(510) 232-0874
(510) 232-8652
Mailing address
PO BOX 70072, RICHMOND, CA 94807-0072
(510) 375-0891
(510) 232-8652
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
CA 043351
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00433510
—
CA
Enumeration date
03/27/2007
Last updated
09/06/2023
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