Moore, Jeremy Paul
Moore, Jeremy Paul is an individual health care provider with primary practice located at 10833 Le Conte Ave B265, Los Angeles CA 90095-3075. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Moore, Jeremy Paul can be contacted via phone (310) 825-0867.Contact Information
Primary practice address
10833 Le Conte Ave B265
Los Angeles CA 90095-3075
Phone: (310) 825-0867
Fax: (310) 825-9524
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A88084 | California |
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | A88084 | California |
Profile Details
| NPI number | 1265676274 |
|---|---|
| LBN Legal business name | Moore, Jeremy Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 22nd, 2009 |
| Last updated | Jun 8th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265676274 | NPPES |
| California | Other | 1265676274 | CCS PANELED |
| California | MEDICAID | 00A880840 | CCS PANELED |
| California | MEDICAID | 1265676274 | CCS PANELED |
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