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General NPI Number Information
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NPI Number | 1063603256
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Entity Type | Individual
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Provider Name | ALVARO MORENO II MD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 2003 KOOTENAI HEALTH WAY
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City | COEUR D ALENE
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State | ID
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Zip | 83814-6051
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Country | US
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Telephone | 208-625-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1768 BUSINESS CENTER DR STE 100
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City | RESTON
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State | VA
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Zip | 20190-5359
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Country | US
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Telephone | 800-762-9244
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Fax | 786-672-6006
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A147898
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M-16878
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | P7517
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License Number State | TX
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