Most Relevant Information
Provider Data
| NPI Number: | 1003691130 |
| Provider Name: | NICHOLAS TRINIDAD MORAN |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/28/2023 |
| Last Updated: | 08/28/2023 |
Provider Practice Location
867 N FAIR OAKS AVE
PASADENA
CA
911033050
Practice Location Phone/Fax
| Phone: | 6267986793 |
| Fax: |
Provider Mailing Location
760 MOUNTAIN VIEW ST
ALTADENA
CA
910014925
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |