Provider Demographics
NPI:1902959802
Name:MORAN, TERRANCE JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:JAMES
Last Name:MORAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:576 HARTNELL ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2833
Mailing Address - Country:US
Mailing Address - Phone:831-625-4765
Mailing Address - Fax:831-658-3005
Practice Address - Street 1:576 HARTNELL ST
Practice Address - Street 2:SUITE 260
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2833
Practice Address - Country:US
Practice Address - Phone:831-625-4765
Practice Address - Fax:831-658-3005
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG-26704174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist