Juanita A Moore, physician Assistant
Physician Assistant, Medical in Rancho Mirage, CA. Individual provider (NPI-1).
NPI number1881920007
StatusActive
Last updated in NPPESDec 14, 2015
Details
- NPI
- 1881920007
- Entity type
- Individual (NPI-1)
- Name
- Juanita A Moore
- Credential
- physician Assistant
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 22, 2009
- Last updated
- Dec 14, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA20555 | CA | Yes |
Practice location
39000 Bob Hope DrEmergency Department
Rancho Mirage, CA 92270-3221
Phone 760-773-1221
Mailing address
39000 Bob Hope DrEmergency Department
Rancho Mirage, CA 92270-3221
Phone 760-773-1221
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