Healthcare Provider Details

I. General information

NPI: 1073943551
Provider Name (Legal Business Name): LINDSAY MARGARET MORAN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 N EL CAMINO REAL STE. D200
ENCINITAS CA
92024-1328
US

IV. Provider business mailing address

7675 DAGGET ST STE 370
SAN DIEGO CA
92111-2260
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-8935
  • Fax: 760-452-3344
Mailing address:
  • Phone: 858-309-6585
  • Fax: 858-309-6593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95083773
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number111603
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: