Individual
JASON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4061 KARELIA ST, LOS ANGELES, CA 90065-3307
(323) 309-9919
Mailing address
4061 KARELIA ST, LOS ANGELES, CA 90065-3307
(323) 309-9919
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
51739
CA
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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