Healthcare Provider Details

I. General information

NPI: 1316679087
Provider Name (Legal Business Name): NATALIE MORALES CRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 ROSECRANS AVE STE 202
MANHATTAN BEACH CA
90266-2470
US

IV. Provider business mailing address

1200 ROSECRANS AVE STE 202
MANHATTAN BEACH CA
90266-2470
US

V. Phone/Fax

Practice location:
  • Phone: 310-957-5524
  • Fax:
Mailing address:
  • Phone: 310-957-5524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number41898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: