Healthcare Provider Details

I. General information

NPI: 1023086717
Provider Name (Legal Business Name): JOHN C. MORETTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 CALIFORNIA ST
SAN FRANCISCO CA
94118-1618
US

IV. Provider business mailing address

PO BOX 26060
FRESNO CA
93729
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-2200
  • Fax: 415-750-5001
Mailing address:
  • Phone: 559-455-4000
  • Fax: 559-455-4004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberG74214
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: