Individual
CARLOS L MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
869 N. CHERRY STREET, TULARE, CA 93274-2207
(209) 668-0821
(269) 659-6738
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301072895
MI
207L00000X
Anesthesiology Physician
Primary
A86872
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4830843
—
MI
Enumeration date
04/22/2006
Last updated
12/30/2016
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