MEDICARE: MARGARET MORALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1710708714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET MORALES

Provider Business Mailing Address
First Line	:	453 S INDIANA ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90063-3908
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	761 HOEFNER AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-3319
Country	:	US
Telephone Number	:	323-317-0322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2024
Last Update Date	:	10/22/2024

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