Individual
FRED MCMOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13781 CHAGALL CT, MORENO VALLEY, CA 92553-6607
(951) 255-5347
Mailing address
1161 HIDDEN VALLEY PKWY STE 114, NORCO, CA 92860-3917
(951) 817-0230
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36518
CA
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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