NPIMap

Organization Active NPI

Lisa C Moore MD Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Santa Monica, CA
National Provider Identifier
1720177439
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A71398 Issued in CA
Legal business name
LISA C MOORE MD INC
Practice address
2021 Santa Monica Blvd
#212E
Santa Monica, CA 90404-2208
Phone
(310) 829-4528
Fax
(310) 453-4348
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Lisa Catherine Moore, MD
Title
President/Physician
Phone
(310) 829-4528

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X A71398 CA Primary

Addresses

Primary practice location

2021 Santa Monica Blvd
#212E
Santa Monica, CA 90404-2208

Mailing address

2021 Santa Monica Blvd
#212E
Santa Monica, CA 90404-2208
Phone (310) 829-4528

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1720177439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "#212E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-4528",
            "fax_number": "310-453-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "#212E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-4528",
            "fax_number": "310-453-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA C MOORE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "310-829-4528",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A71398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.