Provider Demographics
NPI:1700375912
Name:MOORE, KRISTINA MICHELE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:MICHELE
Last Name:MOORE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41200 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9479
Mailing Address - Country:US
Mailing Address - Phone:951-461-1481
Mailing Address - Fax:
Practice Address - Street 1:41200 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9479
Practice Address - Country:US
Practice Address - Phone:951-461-1481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist