Dr. Kyle Anthony Moore
Internist - Addiction Medicine
1313 Cutting Blvd
Richmond
, California 94804-2554
Dr. Kyle Anthony Moore
Internist - Addiction Medicine
1313 Cutting Blvd
Richmond
, California 94804-2554
(510) 232-8652
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About
Features
Specialties
- Internist - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. Kyle Anthony Moore
- Po Box 70072
- Richmond, CA
- Zip : 94807-0072
- Fax : (510) 232-8652
- Phone : (510) 375-0891
Second Address
- Dr. Kyle Anthony Moore
- 1313 Cutting Blvd
- Richmond, CA
- Zip : 94804-2554
- Fax : (510) 232-8652
- Phone : (510) 232-0874
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0401X | Internist - Addiction Medicine | CA 043351 | CA |
National Provider Identifier
| NPI | 1568580322 |
|---|---|
| Provider Name | Dr. Kyle Anthony Moore |
| First Address | Richmond, CA 94807-0072 |
| Second Address | Richmond, CA 94804-2554 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/03/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00433510 | (05) | CA |
| E01674 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.