Alex Moreno, M.D., Medical Group, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A78052 Issued in CA

Legal business name

ALEX MORENO, M.D., MEDICAL GROUP, INC

Practice address

1523 E Amar Rd
Suite E
West Covina, CA 91792-1619

Phone

(626) 839-9100

Fax

(626) 839-9106

NPI assigned

Jul 1, 2009

Organization subpart

No

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

Authorized official

Name

Shura A. Moreno, M.D.

Title

Director

Phone

(626) 839-9100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1679701320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 E AMAR RD",
            "address_2": "SUITE E",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921619",
            "telephone_number": "626-839-9100",
            "fax_number": "626-839-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 E AMAR RD",
            "address_2": "SUITE E",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921619",
            "telephone_number": "626-839-9100",
            "fax_number": "626-839-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX MORENO, M.D., MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "SHURA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-839-9100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in West Covina, CA
• Providers in West Covina, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.