Dr. Theodore Bruce Moore
M.D. | Pediatric Hematology-Oncology | Male
Dr. Theodore Bruce Moore, M.D. is a Los Angeles, California based Pediatric doctor with medical specialization in
Pediatric Hematology-Oncology.
Current practice location of Dr. Theodore Bruce Moore is
10833 Le Conte Ave, 12-441 Mdcc, Los Angeles, California - 90095-3075. He can be contacted on phone at
310-825-6708 and fax number 310-206-8089.
Dr. Theodore Bruce Moore is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Theodore Bruce Moore is
1710091020 which was assigned by NPPES on 17 Aug, 2006 and it was last updated on 27 Aug, 2012.
Dr. Theodore Bruce Moore license number is
G69308 for Pediatrics Pediatric Hematology-Oncology (2080P0207X) in California.
Dr. Theodore Bruce Moore is trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
Complete Profile:
Dr. Theodore Bruce Moore basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Hematology-Oncology |
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| Provider Name : | Dr. Theodore Bruce Moore |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Dr. Theodore Bruce Moore address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 10833 Le Conte Ave, 12-441 Mdcc
Los Angeles, CA, 90095-3075
United States |
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| Phone Number : | 310-825-6708 |
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| Fax Number : | 310-206-8089 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1710091020 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 17 Aug, 2006 |
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| Last Updated On : | 27 Aug, 2012 |
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Medicare Participation:
Dr. Theodore Bruce Moore participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 7012189293 |
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| Medicare Enrollment ID : | I20111012000256 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | Oregon Health Sciences University School Of Medicine |
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| Graduation Year : | 1989 |
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| Accepts Medicare? | Yes. Dr. Theodore Bruce Moore accepts medicare insurance. |
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Group Practice Association:
Dr. Theodore Bruce Moore is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Theodore Bruce Moore is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| Uc Regents | 4587568829 | 73 | 10833 Le Conte Ave
A2 410
Los Angeles, CA - 900953075
Ph: 3102064616 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Theodore Bruce Moore are as mentioned. Primary taxonomy code for Dr. Theodore Bruce Moore, M.D. is
2080P0207X (Pediatrics Pediatric Hematology-Oncology).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0207X | Pediatrics Pediatric Hematology-Oncology | Yes | G69308 | CA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Theodore Bruce Moore such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| GR0053510 | MEDICAID | CA | |
| 00G693080 | MEDICAID | CA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 10833 Le Conte Ave, 12-441 Mdcc
Los Angeles, CA, 90095-3075
United States |
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| Phone Number : | 310-825-6708 |
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| Fax Number : | 310-206-8089 |
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Business Location:
Patients can refer following map for directions to
Dr. Theodore Bruce Moore practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.