Organization
DR. J. SOLOMON MOORE, OD & ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN SOLOMON MOORE O.D. (PRESIDENT)
(818) 785-4040
Entity
Organization
Contact information
Practice address
14434 HAMLIN ST, SUITE 1, VAN NUYS, CA 91401-1461
(818) 785-4040
(818) 785-4608
Mailing address
14434 HAMLIN ST, SUITE 1, VAN NUYS, CA 91401-1461
(818) 785-4040
(818) 785-4608
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
COR 773
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD004120
—
CA
Enumeration date
01/30/2007
Last updated
01/03/2008
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