Moore, Brian S

Moore, Brian S is an individual health care provider with primary practice located at 5555 Grossmont Center Dr , La Mesa CA 91942-3019. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Moore, Brian S can be contacted via phone (619) 740-4000.

Contact Information

Primary practice address
5555 Grossmont Center Dr La Mesa CA 91942-3019
Phone: (619) 740-4000
Fax: (619) 740-4207
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G683360 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G68336 California
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X G68336 California

Profile Details

NPI number 1831144005
LBN Legal business name Moore, Brian S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Mar 19th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831144005 NPPES
California MEDICAID 00G683360
California Other 00G683360
California Other 10963841

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