Provider Demographics
NPI:1386917326
Name:METRO MEDICAL ASSOCIATES, INC
Entity type:Organization
Organization Name:METRO MEDICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:JR
Authorized Official - Credentials:M-D
Authorized Official - Phone:213-386-9970
Mailing Address - Street 1:2500 WILSHIRE BLVD.,
Mailing Address - Street 2:SUITE 900
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-4314
Mailing Address - Country:US
Mailing Address - Phone:213-386-9970
Mailing Address - Fax:213-386-9972
Practice Address - Street 1:2500 WILSHIRE BL
Practice Address - Street 2:#900
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4314
Practice Address - Country:US
Practice Address - Phone:213-386-9970
Practice Address - Fax:213-386-9972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty