IndividualActive
Kevin Moore, IDMT
NPI 1649404807 · Independent Duty Medical Technicians · Travis Afb, CA
Provider details
- NPI number
- 1649404807
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
101 Bodin Cir
Sgpf
Travis Afb, CA 94535-1809
Phone: (707) 423-7225
Fax: (707) 423-5026
Approximate (ZIP-level) locationGet directions
Mailing address
101 Bodin Cir
Travis Afb, CA 94535-1809
Registry dates
- Enumerated
- 2009-05-03
- Last updated
- 2009-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.