TISHA MOORE

LOS ANGELES, CA
NPI1326067901
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: CA  PA16773)
Additional Taxonomies363AS0400X Physician Assistant, Surgical
(Licence: CA  PA16773)
Enumeration Date2006-07-18
Last Update Date2012-08-27
Business Address
-- TISHA MOORE pa
10833 LE CONTE AVE
LOS ANGELES, CA 90095-3075
Phone number: 310-303-6204
Mailing Address
-- TISHA MOORE pa
FILE 2939
LOS ANGELES, CA 90074-2939
Phone number: 310-301-8709