Provider Demographics
NPI:1043062334
Name:MOREO, HUNTER MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:MARIE
Last Name:MOREO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11770 BERNARDO PLAZA CT STE 270
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2425
Mailing Address - Country:US
Mailing Address - Phone:858-485-0554
Mailing Address - Fax:
Practice Address - Street 1:11770 BERNARDO PLAZA CT STE 270
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2425
Practice Address - Country:US
Practice Address - Phone:858-485-0554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical