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NPI Code Detail

MEDICARE: NOEMY MORENO

MEDICARE: NOEMY MORENO
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
1363LF0000XFamily Nurse Practitioner95036355CA

General Provider Information

NPI Number : 1740164763
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOEMY MORENO
Provider Business Mailing Address
First Line : 1120 W WASHINGTON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3316
Country : US
Telephone Number : 213-623-2225
Fax Number :
Provider Business Practice Location Address
First Line : 1120 W WASHINGTON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3316
Country : US
Telephone Number : 213-623-2225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2025
Last Update Date : 06/10/2026

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