Healthcare Provider Details

I. General information

NPI: 1063320604
Provider Name (Legal Business Name): KARL MORIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 W BADILLO ST
COVINA CA
91723-1829
US

IV. Provider business mailing address

444 W BADILLO ST
COVINA CA
91723-1829
US

V. Phone/Fax

Practice location:
  • Phone: 626-967-1819
  • Fax:
Mailing address:
  • Phone: 626-437-4308
  • Fax: 626-437-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: