Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A152634 | CA |
Y | 111NI0900X | Internist | A152634 | CA |
N | 207RN0300X | Nephrologist | A152634 | CA |
NPI | 1013325752 |
---|---|
Provider Name | Carlos Hernando Moreno Castaneda |
First Address | Winter Park, FL 32789-4870 |
Second Address | Bakersfield, CA 93301-1277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2014 |
Last Update Date | 16/06/2021 |