Michie Moreno, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A52079 Issued in CA

Practice address

1720 W Ball Rd
Suite 3C
Anaheim, CA 92804-5500

Phone

(714) 533-7005

NPI assigned

Jan 9, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1033356209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 W BALL RD",
            "address_2": "SUITE 3C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928045500",
            "telephone_number": "714-533-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W BALL RD",
            "address_2": "SUITE 3C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928045500",
            "telephone_number": "714-533-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MICHIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A52079",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A52079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystle Ann Moreno
• Laura Moreno
• Linda Moreno
• Marissa Moreno
• Michelle Eugenia Moreno
• Nia Moreno
• Paula J Moreno, NP
• Reyna Moreno, LMFT
• Rafael Morfin
• Morgan Dental Corporation

• General Practice Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.