Individual
BRYAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
245 VICTORIA ST, SUITE 1H, COSTA MESA, CA 92627
(949) 629-2860
(949) 629-2867
Mailing address
20423 VIA DON JUAN, YORBA LINDA, CA 92886-3047
(714) 650-6061
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
735990
CA
Other
Enumeration date
04/21/2016
Last updated
12/02/2025
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