Provider Demographics
NPI:1053975227
Name:C&C MORENO REGISTERED NURSING INC
Entity type:Organization
Organization Name:C&C MORENO REGISTERED NURSING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:213-674-7769
Mailing Address - Street 1:635 S WESTLAKE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3525
Mailing Address - Country:US
Mailing Address - Phone:213-674-7769
Mailing Address - Fax:
Practice Address - Street 1:635 S WESTLAKE AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3525
Practice Address - Country:US
Practice Address - Phone:213-674-7769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty