Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A149708 | CA |
NPI | 1255776449 |
---|---|
Provider Name | Annie Renee Layno-Moses |
First Address | Santa Monica, CA 90403-4801 |
Second Address | Santa Monica, CA 90403-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2013 |
Last Update Date | 12/08/2019 |