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Individual

EDIE MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
23451 MADISON ST STE 330, TORRANCE, CA 90505-4762
(310) 375-9994
Mailing address
23451 MADISON ST STE 330, TORRANCE, CA 90505-4762
(310) 375-9994

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12851
CA

Other

Enumeration date
06/10/2011
Last updated
06/10/2011
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