Individual
LYDIA IRENE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
23961 CALLE DE LA MAGDALENA STE 334, LAGUNA HILLS, CA 92653-3665
(949) 951-6019
Mailing address
584 HIGH DR, LAGUNA BEACH, CA 92651-1558
(949) 951-5437
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NPF7346
CA
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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