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NPI Code Detail

MEDICARE: COREY MOORE

MEDICARE: COREY MOORE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1982538658
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY MOORE
Provider Business Mailing Address
First Line : 1333 S MAYFLOWER AVE STE 220
Second Line :
City : MONROVIA
State : CA
Zip : 91016-5239
Country : US
Telephone Number : 818-241-6780
Fax Number : 818-241-6780
Provider Business Practice Location Address
First Line : 1333 S MAYFLOWER AVE STE 220
Second Line :
City : MONROVIA
State : CA
Zip : 91016-5239
Country : US
Telephone Number : 818-241-6780
Fax Number : 818-241-6780
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ COREY MOORE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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