Individual
MOISES VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
412 TH MEDICAL GROUP, 30 NIGHTINGALE RD., EDWARDS AFB, CA 93524-0001
(661) 277-1130
Mailing address
412 TH MEDICAL GROUP, 30 NIGHTINGALE RD., EDWARDS AFB, CA 93524-0001
(661) 277-1130
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/31/2009
Last updated
01/06/2013
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