Provider Demographics
NPI:1205001435
Name:MORONI CHS INC
Entity Type:Organization
Organization Name:MORONI CHS INC
Other - Org Name:INCORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JAME
Authorized Official - Last Name:WEAGRAFF
Authorized Official - Suffix:SR
Authorized Official - Credentials:EDD PHD
Authorized Official - Phone:949-699-3640
Mailing Address - Street 1:21663 PASEO CASIANO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692
Mailing Address - Country:US
Mailing Address - Phone:949-699-3640
Mailing Address - Fax:949-699-3640
Practice Address - Street 1:21663 PASEO CASIANO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692
Practice Address - Country:US
Practice Address - Phone:949-699-3640
Practice Address - Fax:949-699-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable