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General NPI Number Information
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NPI Number | 1205001435
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Entity Type | Organization
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Legal Business Name | MORONI CHS INC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 21663 PASEO CASIANO
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City | MISSION VIEJO
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State | CA
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Zip | 92692
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Country | US
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Telephone | 949-699-3640
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Fax | 949-699-3640
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Provider Business Mailing Address
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Address Line | 21663 PASEO CASIANO
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City | MISSION VIEJO
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State | CA
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Zip | 92692
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Country | US
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Telephone | 949-699-3640
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Fax | 949-699-3640
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Authorized Official
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Title or Position | CEO
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Name | DR. PATRICK JAME WEAGRAFF SR.
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Credential | EDD PHD
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Telephone | 949-699-3640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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