Individual
DR. CHARLES J. MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1763 RAMADA DRIVE, PASO ROBLES, CA 93446
(805) 226-0902
Mailing address
1763 RAMADA DRIVE, PASO ROBLES, CA 93446
(805) 226-0902
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G48369
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G483690
—
CA
01
—
0245163
WASHINGTON STATE DOL
CA
01
—
7206086
AETNA PIN
CA
Enumeration date
01/17/2007
Last updated
10/21/2009
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