Active NPI
Deborah Daretany Moran, MD
- Internal Medicine Physician
- Los Angeles, CA
National Provider Identifier
1548337553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A56498
- Practice address
- 11301 Wilshire Blvd
BLDG 500 Room 2058
Los Angeles, CA 90073-1003 - Phone
- (301) 478-3711
- Fax
- (310) 268-4272
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A56498 | CA | Primary |
Addresses
Primary practice location
11301 Wilshire Blvd
BLDG 500 Room 2058
Los Angeles, CA 90073-1003
Mailing address
11301 Wilshire Blvd
BLDG 500 Room 2058
Los Angeles, CA 90073-1003
Phone (301) 478-3711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A564980 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130522000574 | CA | Order and Referring Only - Internal Medicine | 1557375573 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364342400000",
"number": "1548337553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"address_2": "BLDG 500 ROOM 2058",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "301-478-3711",
"fax_number": "310-268-4272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"address_2": "BLDG 500 ROOM 2058",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "301-478-3711",
"fax_number": "310-268-4272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "DEBORAH",
"middle_name": "DARETANY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2013-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A56498",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A564980",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.