Moreno, Christopher Al
Moreno, Christopher Al is an individual health care provider with primary practice located at 307 St. Johns Way Suite 11, Lewiston ID 83501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Moreno, Christopher Al can be contacted via phone (208) 743-7612.Contact Information
Primary practice address
307 St. Johns Way Suite 11
Lewiston ID 83501
Phone: (208) 743-7612
Fax: (208) 746-4802
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | M5071 | Idaho |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD00024021 | Washington |
Profile Details
| NPI number | 1275589905 |
|---|---|
| LBN Legal business name | Moreno, Christopher Al |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Sep 20th, 2007 - about 19 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 | 1275589905 | NPPES |
| Idaho | Other | 000010002753 | REGENCE BLUE SHIELD OF ID |
| Idaho | Other | D0782 | REGENCE BLUE SHIELD OF ID |
| Idaho | Other | 8909565 | REGENCE BLUE SHIELD OF ID |
| Idaho | MEDICAID | 1021856 | REGENCE BLUE SHIELD OF ID |
| Idaho | MEDICAID | 002599100 | REGENCE BLUE SHIELD OF ID |
| Idaho | Other | 0096144 | REGENCE BLUE SHIELD OF ID |
| Idaho | Other | 020006062 | REGENCE BLUE SHIELD OF ID |
| Idaho | Other | 82040040083501A003 | REGENCE BLUE SHIELD OF ID |
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