Provider Demographics
NPI:1629873872
Name:MORAN, JULIO (MPH CHES)
Entity type:Individual
Prefix:MR
First Name:JULIO
Middle Name:
Last Name:MORAN
Suffix:
Gender:M
Credentials:MPH CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 84TH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-3005
Mailing Address - Country:US
Mailing Address - Phone:818-536-9906
Mailing Address - Fax:
Practice Address - Street 1:333 E 84TH PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-3005
Practice Address - Country:US
Practice Address - Phone:818-536-9906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty