Moore, Jan Solomon

Moore, Jan Solomon is an individual health care provider with primary practice located at 14434 Hamlin St Suite 1, Van Nuys CA 91401-1461. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moore, Jan Solomon can be contacted via phone (818) 785-4040.

Contact Information

Primary practice address
14434 Hamlin St Suite 1 Van Nuys CA 91401-1461
Fax: (818) 785-4608
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 8910TPL California

Profile Details

NPI number 1891874731
LBN Legal business name Moore, Jan Solomon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Jan 22nd, 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 1891874731 NPPES
California MEDICAID SD0089100

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