Individual provider · Type 1 NPI

Addie Moore

Student in an Organized Health Care Education/Training Program · Gardena, CA

NPI number 1154029270 Active

Practice location

1149 W 190th St Ste 2200
Gardena, CA 90248-4344

Call (310) 856-0800 Map

Fax (855) 568-2494

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1154029270

Addie Moore's National Provider Identifier is 1154029270, issued on Feb 17, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Gardena, CA. The record was last updated on Jul 23, 2026.