DR. SAM PUTRES KHUMOORO (NPI# 1962543504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962543504 |
| Entity Type | Individual |
| Full Name | DR. SAM PUTRES KHUMOORO |
| Credential | D.C. |
| Practice Address |
23080 Alessandro Blvd Ste 204 Moreno Valley CA 92553-9674 |
| Practice Telephone | 9515714090 |
| Practice Fax Number | 9515714091 |
| Mailing Telephone | 9515714090 |
| Mailing Fax Number | 9515714091 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC-25727 | CA | Chiropractic Providers |
| Street Address |
23080 ALESSANDRO BLVD STE 204 |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92553-9674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104441559 | Tanya Gentle | Marriage & Family Therapist | 2319 Cottonwood Avenue, Building A Suite 110, Moreno Valley, CA 92553 | 2020-06-11 |
| 1275194227 | Antonio Pearce | Psychologist | 12968 Frederick Street, Suite D, Moreno Valley, CA 92553 | 2019-06-20 |
| 1346726486 | Elias Y. Rached | Chiropractor | 23846 Sunnymead Blvd Ste 4, Moreno Valley, CA 92553 | 2018-07-12 |
| 1952813420 | Shanaya Frederick | Driver | 14929 Spinnaker Lane, Moreno Valley, CA 92553 | 2017-10-24 |
| 1457879413 | R & C Logistic Services, LLC | Private Vehicle | 14768 Briana St, Moreno Valley, CA 92553 | 2017-08-30 |
| 1720505084 | Elda Pricila Hernandez | Behavioral Analyst | 24596 Atwood Ave.apt1, Moreno Valley, CA 92553 | 2017-08-28 |
| 1174044101 | Ps Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 24594 Sunnymead Blvd, Suite M, Moreno Valley, CA 92553 | 2017-06-29 |
| 1942736327 | Richard Pantoja Reyna | Licensed Vocational Nurse | 23119 Cottonwood Ave Bld A Suite 110, Moreno Valley, CA 92553 | 2017-05-04 |
| 1255872719 | Sibonisiwe Moyo Johnson | Nurse Practitioner | 22555 Alessandro Blvd Ste B, Moreno Valley, CA 92553 | 2017-03-16 |
| 1518311190 | Ryan Macavinta | Nurse Practitioner | 22765 Alessandro Blvd., Moreno Valley, CA 92553 | 2016-04-20 |
| Find all providers in zip 92553 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346726486 | Elias Y. Rached | Chiropractor | 23846 Sunnymead Blvd Ste 4, Moreno Valley, CA 92553 | 2018-07-12 |
| 1376852251 | Chang Cho Chung | Chiropractor | 24578 Sunnymead Bl., # C/d, Moreno Valley, CA 92553 | 2010-09-27 |
| 1598927378 | Ronald Soriano | Chiropractor | 11365 Quincy St, Moreno Valley, CA 92555-6586 | 2008-07-02 |
| 1821269440 | Carla Asante Mcmorris | Chiropractor | 24580 Sunnymead Blvd, H, Moreno Valley, CA 92553-3761 | 2008-03-23 |
| 1407998149 | Kanak D. Patel | Chiropractor | 16420 Perris Blvd Ste Q, Moreno Valley, CA 92551-1136 | 2007-02-12 |
| 1720135122 | Derick J Lajom | Chiropractor | 23750 Alessandro Blvd Ste I102, Moreno Valley, CA 92553-8815 | 2007-01-05 |
| 1205991098 | Patrick Daniel Fairchild | Chiropractor | 23890 Alessandro Blvd Suite F, Moreno Valley, CA 82553 | 2006-12-22 |
| 1083784870 | Norman E Corlew | Chiropractor | 23890 Alessandro Blvd, Suite F, Moreno Valley, CA 92553-0312 | 2006-11-08 |
| 1780768200 | Christina Burkhardt | Chiropractor | 25400 Alessandro Blvd, 102, Moreno Valley, CA 92553-4319 | 2006-10-24 |
| 1063500890 | Berinson Chiropractic Inc | Chiropractor | 24578 Sunnymead Blvd, Suite C & D, Moreno Valley, CA 92553 | 2006-10-10 |
| Find all providers in MORENO VALLEY | ||||
| City | MORENO VALLEY |
| Zip Code | 92553 |
Please comment or provide details below to improve the information on DR. SAM PUTRES KHUMOORO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.