MEDICARE: ANNIE RENEE LAYNO-MOSES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	A149708	CA

General Provider Information

NPI Number	:	1255776449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE RENEE LAYNO-MOSES

Provider Business Mailing Address
First Line	:	2801 WILSHIRE BLVD STE A
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4801
Country	:	US
Telephone Number	:	310-574-2777
Fax Number	:

Provider Business Practice Location Address
First Line	:	588 BROADWAY RM 710
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-5242
Country	:	US
Telephone Number	:	212-804-9060
Fax Number	:

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

Provider Enumeration Date	:	05/01/2013
Last Update Date	:	09/14/2022

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Directions to “ ANNIE RENEE LAYNO-MOSES ” Practice Location

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