Organization
ROBERT A. MOORE, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ALLEN MOORE M.D. (OWNER)
(949) 764-8070
Entity
Organization
Contact information
Practice address
1501 SUPERIOR AVE, STE. 202, NEWPORT BEACH, CA 92663-3600
(949) 764-8070
(949) 650-4585
Mailing address
1501 SUPERIOR AVE, STE. 202, NEWPORT BEACH, CA 92663-3600
(949) 764-8070
(949) 650-4585
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
G43085
CA
2084N0400X
Neurology Physician
Primary
G43085
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI158A
MEDICARE PTAN # CI158A
CA
Enumeration date
08/04/2009
Last updated
12/08/2009
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