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NPI Code Detail

MEDICARE: JORGE MORALES

MEDICARE: JORGE MORALES
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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1770891822
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE MORALES
Provider Business Mailing Address
First Line : 301 GRAND AVE STE 301
Second Line :
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-3641
Country : US
Telephone Number : 650-244-1444
Fax Number : 650-244-1447
Provider Business Practice Location Address
First Line : 301 GRAND AVE STE 301
Second Line :
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-3641
Country : US
Telephone Number : 650-244-1444
Fax Number : 650-244-1447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2010
Last Update Date : 09/22/2010

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Directions to “ JORGE MORALES ” Practice Location

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