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General NPI Number Information
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NPI Number | 1194784025
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Entity Type | Individual
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Provider Name | PATRICK M MOORE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 28078 BAXTER RD SUITE 420
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City | MURRIETA
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State | CA
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Zip | 92563-1402
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Country | US
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Telephone | 951-566-9370
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Fax | 951-200-4401
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Provider Business Mailing Address
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Address Line | 29910 MURRIETA HOT SPRINGS ROAD SUITE G345
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City | MURRIETA
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State | CA
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Zip | 92563-3814
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Country | US
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Telephone | 951-566-9370
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Fax | 951-200-4401
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD00032619
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C53431
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License Number State | CA
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