Epidaurus

Specialty details in registry · Moreno Valley, CA

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At a glance

13800 Heacock St Ste C224, Moreno Valley, CA 92553-6267

NPPES record updated Jul 9, 2025. Public records can lag behind changes at a practice.

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Practice location

13800 Heacock St Ste C224
Moreno Valley, CA 92553-6267

Professional details: NPI, taxonomy & registry record

NPI1639060668

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 251B00000X
Enumeration date: Jul 9, 2025
Record updated: Jul 9, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251B00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

13800 Heacock St Ste C224
Moreno Valley, CA 92553-6267

Phone: (323) 387-9146

Mailing address

PO BOX 3043

TUCSON, AZ 857023043

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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