Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TRACY MOORE
ActiveTRACY MOORE is a Sports Medicine (PM&R) healthcare provider located in SAN DIMAS, California. NPI 1497388417 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · SAN DIMAS, CA
Registration Details
- NPI Number
- 1497388417
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 18, 2020 (6.5313334860367 yrs)
- Last Updated
- Feb 18, 2020
- License
-
298059 (CA)
Practice Information
- Address
-
1335 CYPRESS ST STE 100SAN DIMAS, CA, 917733538Browse CA providers · Browse ZIP 91773
- Phone
- 9093051383
- Fax
- 9093051435
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.