Dorothy Gwen Moore, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G69762 Issued in CA

Practice address

626 N Paulina Ave
Redondo Beach, CA 90277-3022

Phone

(310) 372-1998

NPI assigned

Mar 9, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1394323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394323200000",
    "number": "1578989059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N PAULINA AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773022",
            "telephone_number": "310-372-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 N PAULINA AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773022",
            "telephone_number": "310-372-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DOROTHY",
        "middle_name": "GWEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-09",
        "last_updated": "2014-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Shereen Momand, M.D.
• Elizabeth Monday, M.A., BCBA
• Jon Mark Monette, D.D.S.
• Chelsea Lea Montgomery
• Tisha Montiero
• Kathleen L. Moore, PH.D.
• Darby Mora, PA-C
• Ana Karen Moreno, LCSW
• Roxanne Horta Moreno, LCSW
• Jill Marie Morgan

• Family Medicine Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2014; 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.