| Jorge L Moran MD Inc | |
|
210 S Locust St Inglewood CA 90301-2304 | |
| (310) 673-9920 | |
| (310) 673-9919 |
| Full Name | Jorge L Moran MD Inc |
|---|---|
| Speciality | General Practice |
| Location | 210 S Locust St, Inglewood, California |
| Authorized Official Name and Position | Jorge L Moran (PRESIDENT) |
| Authorized Official Contact | 3106739920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jorge L Moran MD Inc 210 S Locust St Inglewood CA 90301-2304 Ph: (310) 673-9920 | Jorge L Moran MD Inc 210 S Locust St Inglewood CA 90301-2304 Ph: (310) 673-9920 |
| NPI Number | 1487795753 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 03/09/2018 |
| Medicare PECOS PAC ID | 3870689730 |
|---|---|
| Medicare Enrollment ID | O20071023000803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487795753 | NPI | - | NPPES |
| 00A636620 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A63662 (California) | Primary |
| Provider Name | Jorge L Moran |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1699790667 PECOS PAC ID: 8123927514 Enrollment ID: I20040105000746 |
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