Moulton Family Medicine

LBN: Moulton Family Medicine
Moulton Family Medicine is an health care organization with primary practice located at 22611 Lake Forest Dr C-4, Lake Forest CA 92630-1700. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Moulton Family Medicine can be contacted via phone (949) 951-9399, or through Heine, Kenny via phone (858) 625-2990.

Contact Information

Primary practice address
22611 Lake Forest Dr C-4 Lake Forest CA 92630-1700
Phone: (949) 951-9399
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Heine, Kenny
Phone: (858) 625-2990

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X A47792 California

Profile Details

NPI number 1164564712
LBN Legal business name Moulton Family Medicine
DBA Doing business as
Authorized official Heine, Kenny
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 12th, 2007
Last updated Oct 17th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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