Individual provider Active NPI

Jorge Luis Moran, M.D.

  • General Practice Physician
  • Inglewood, CA
National Provider Identifier
1699790667
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A63662 Issued in CA
Practice address
210 S Locust St
Inglewood, CA 90301-2304
Phone
(310) 673-9920
Fax
(310) 673-9919
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A63662 CA Primary

Addresses

Primary practice location

210 S Locust St
Inglewood, CA 90301-2304

Mailing address

210 S Locust St
Inglewood, CA 90301-2304
Phone (310) 673-9920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040105000746 CA Practitioner - General PracticePractitioner - Family Practice 8123927514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 S Locust St
Inglewood, CA 90301-2304
Phone (310) 673-9920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jorge L Moran MD Inc General Practice CurrentSince Apr 30, 2003 Accepting new patients
BVC Therapy Group PastSince Jul 24, 2022 Accepting new patients
Mahfouz M. Michael,M.D.,Inc. General Practice Past Accepting new patients
Spinal Rehabilitation Medical Group Inc Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Eladh, LP PastSince Sep 18, 2006 Accepting new patients

Locations

210 S Locust St
Inglewood, CA 90301
Phone (213) 481-1241

12340 Santa Monica Blvd
Ste 101
Los Angeles, CA 90025
Phone (310) 458-1259

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1699790667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S LOCUST ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903012304",
            "telephone_number": "310-673-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S LOCUST ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903012304",
            "telephone_number": "310-673-9920",
            "fax_number": "310-673-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A63662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.