MEDICARE: HUNTER MARIE MOREO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363AM0700X	Medical Physician Assistant
2	363AS0400X	Surgical Physician Assistant
3	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1043062334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUNTER MARIE MOREO PA-C

Provider Business Mailing Address
First Line	:	11770 BERNARDO PLAZA CT STE 270
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2425
Country	:	US
Telephone Number	:	858-485-0554
Fax Number	:

Provider Business Practice Location Address
First Line	:	11770 BERNARDO PLAZA CT STE 270
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2425
Country	:	US
Telephone Number	:	858-485-0554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2024
Last Update Date	:	04/02/2024

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Directions to “ HUNTER MARIE MOREO PA-C” Practice Location

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