Tracy Moore
Sports Medicine
1335 Cypress St Ste 100
San Dimas
, California 91773-3538
Tracy Moore
Sports Medicine
1335 Cypress St Ste 100
San Dimas
, California 91773-3538
(909) 305-1435
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About
Features
Specialties
- Sports Medicine
Languages spoken
- English
Location
First Address
- Tracy Moore
- Po Box 99
- San Dimas, CA
- Zip : 91773-0099
- Fax : (909) 305-1435
- Phone : (909) 305-1383
Second Address
- Tracy Moore
- 1335 Cypress St Ste 100
- San Dimas, CA
- Zip : 91773-3538
- Fax : (909) 305-1435
- Phone : (909) 305-1383
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2081S0010X | Sports Medicine | 298059 | CA |
| Y | 213ES0000X | Sports Medicine | 298059 | CA |
National Provider Identifier
| NPI | 1497388417 |
|---|---|
| Provider Name | Tracy Moore |
| First Address | San Dimas, CA 91773-0099 |
| Second Address | San Dimas, CA 91773-3538 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/02/2020 |
| Last Update Date | 18/02/2020 |
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.