| Doctor Name: | DR. JORGE LUIS MORAN |
| NPI Number: | 1699790667 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A63662 |
| Business Practice Address: | 210 S Locust St Inglewood, CA - 903012304 |
| Business Phone Number: | 3106739920 |
| Business Fax Number: | 3106739919 |
| Mailing Address: | 210 S Locust St, INGLEWOOD |
| State: | CA |
| Postal Code: | 903012304 |
| Phone Number: | 3106739920 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 03/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A63662 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |