MEDICARE: CYCLARY MORA

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	2355S0801X	Speech-Language Assistant	7208	CA

General Provider Information

NPI Number	:	1851962807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYCLARY MORA

Provider Business Mailing Address
First Line	:	1113 AMHERST AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5805
Country	:	US
Telephone Number	:	310-553-2695
Fax Number	:	310-553-6718

Provider Business Practice Location Address
First Line	:	1113 AMHERST AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5805
Country	:	US
Telephone Number	:	310-553-2695
Fax Number	:	310-553-6718

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

Provider Enumeration Date	:	07/09/2021
Last Update Date	:	09/21/2023

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Directions to “ CYCLARY MORA ” Practice Location

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