Individual
MIGUEL MORENO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1753 BARBOUR AVE, CHULA VISTA, CA 91913-4314
(619) 921-9638
Mailing address
1753 BARBOUR AVE, CHULA VISTA, CA 91913-4314
(619) 921-9638
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
21918
CA
2279C0205X
Critical Care Registered Respiratory Therapist
21918
CA
2279H0200X
Home Health Registered Respiratory Therapist
21918
CA
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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