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NPI Code Detail

MEDICARE: DR. DANIEL CARL MOORE M.D.

MEDICARE: DR. DANIEL CARL MOORE M.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
1207R00000XInternal Medicine PhysicianA74732CA

General Provider Information

NPI Number : 1841257342
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL CARL MOORE M.D.
Provider Business Mailing Address
First Line : 5553 W 6TH ST
Second Line : #2307
City : LOS ANGELES
State : CA
Zip : 90036-7503
Country : US
Telephone Number : 323-931-7912
Fax Number :
Provider Business Practice Location Address
First Line : 401 S FAIR OAKS AVE
Second Line :
City : PASADENA
State : CA
Zip : 91105-2603
Country : US
Telephone Number : 626-795-2244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 07/08/2007

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