Moore, Brian Leopold
Moore, Brian Leopold is an sole proprietor health care provider with primary practice located at 7621 Canoga Ave , Canoga Park CA 91304-4912. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Moore, Brian Leopold can be contacted via phone (818) 642-1269.Contact Information
Primary practice address
7621 Canoga Ave
Canoga Park CA 91304-4912
Phone: (818) 642-1269
Fax: (818) 598-6937
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY13499 | California |
Profile Details
| NPI number | 1518042753 |
|---|---|
| LBN Legal business name | Moore, Brian Leopold |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Oct 4th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518042753 | NPPES |
| Other | GD050Z | PTAN | |
| Other | GD050Y | PTAN |
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