Tracy Moore, is a
Physical Medicine & Rehabilitation - Sports Medicine physician based in San Dimas, California. Tracy Moore is licensed to practice in California (license number 298059) and his current practice location is 1335 Cypress St Ste 100, San Dimas, California. He can be reached at his office (for appointments etc.) via phone at
(909) 305-1383.
NPI number for Tracy Moore is 1497388417 and his current mailing address is Po Box 99, San Dimas, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1497388417.
Physician's Profile
| Full Name | Tracy Moore |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation - Sports Medicine |
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| Location | 1335 Cypress St Ste 100, San Dimas, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1497388417
- Provider Enumeration Date: 02/18/2020
- Last Update Date: 02/18/2020
Medical Identifiers
Medical identifiers for Tracy Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1497388417 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 298059 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tracy Moore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Tracy Moore, Po Box 99, San Dimas, CA 91773-0099 Ph: (909) 305-1383 | Tracy Moore, 1335 Cypress St Ste 100, San Dimas, CA 91773-3538 Ph: (909) 305-1383 |
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