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NPI Code Detail

MEDICARE: DR. LOUIS MATTHEWS MOORE PH.D.

MEDICARE:  DR. LOUIS MATTHEWS MOORE  PH.D.
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
1103T00000XPsychologistPSY13927CA

General Provider Information

NPI Number : 1437132313
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUIS MATTHEWS MOORE PH.D.
Provider Business Mailing Address
First Line : 2505 W 14TH ST
Second Line : (VA MENTAL HEALTH CLINIC)
City : OAKLAND
State : CA
Zip : 94607-5031
Country : US
Telephone Number : 510-587-3434
Fax Number : 510-587-3420
Provider Business Practice Location Address
First Line : 2505 W 14TH ST
Second Line : (VA MENTAL HEALTH CLINIC)
City : OAKLAND
State : CA
Zip : 94607-5031
Country : US
Telephone Number : 510-587-3434
Fax Number : 510-587-3420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 07/08/2007

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Directions to “ DR. LOUIS MATTHEWS MOORE PH.D.” Practice Location

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