Provider Demographics
NPI:1194784025
Name:MOORE, PATRICK M (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:M
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:29910 MURRIETA HOT SPRINGS ROAD
Mailing Address - Street 2:SUITE G345
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-3814
Mailing Address - Country:US
Mailing Address - Phone:951-566-9370
Mailing Address - Fax:951-200-4401
Practice Address - Street 1:28078 BAXTER RD
Practice Address - Street 2:SUITE 420
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1402
Practice Address - Country:US
Practice Address - Phone:951-566-9370
Practice Address - Fax:951-200-4401
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2017-08-01
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Provider Licenses
StateLicense IDTaxonomies
WAMD00032619208600000X
CAC53431208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC53431OtherCALIFORNIA LICENSE
WAAB24612Medicare ID - Type Unspecified
CAC53431OtherCALIFORNIA LICENSE