DR. THEODORE BRUCE MOORE M.D. NPI 1710091020

NPI Information

DR. Theodore Bruce Moore, M.D. is a pediatric hematology-oncology pediatrics in Los Angeles, CA with 35 years of experience. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. DR. Theodore Bruce Moore, M.D. NPI is 1710091020. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

10833 LE CONTE AVE
12-441 MDCC
LOS ANGELES, CA
ZIP 90095-075
Phone: (310) 825-6708
Fax: (310) 206-8089

The NPI 1710091020 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 8/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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