Moreno, Donnie Jay

Moreno, Donnie Jay is an individual health care provider with primary practice located at 462 Prescott St , Pasadena CA 91104-2858. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Wound Care, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Moreno, Donnie Jay can be contacted via phone (626) 485-2635.

Contact Information

Primary practice address
462 Prescott St Pasadena CA 91104-2858
Phone: (626) 485-2635
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Wound Care 163WW0000X 8CB9E California
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X 1051707 California
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 1051707 California

Profile Details

NPI number 1093584815
LBN Legal business name Moreno, Donnie Jay
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2023
Last updated Jan 29th, 2024 - about 11 months 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 1093584815 NPPES
California MEDICAID 1051707
California Other 8CB9E

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