KOLESTA L MOORE
NPI 1821961194
Rehabilitation Practitioner in Los Angeles, CA
Active since September 24, 2025
About Kolesta L Moore NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KOLESTA L MOORE (NPI 1821961194) is an individual rehabilitation practitioner in Los Angeles, California and active in the NPI registry since September 2025.
NPPES Registry Identity
NPI1821961194
Entity TypeIndividualFemale
Primary Taxonomy225400000X
Provider Legal NameKOLESTA L MOORE
Location Address4601 S BROADWAY STE CLos Angeles, CA 90037-2729
Mailing Address470 E 3rd St Ste CLos Angeles, CA 90013-1630 · (213) 620-5712
Phone(213) 440-7448
Sole ProprietorNo
Enumeration DateSeptember 24, 2025
Last NPPES UpdateOctober 6, 2025
NPPES CertifiedOctober 6, 2025
✔ NPI 1821961194 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225400000X
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
4601 S BROADWAY STE C, Los Angeles, CA 90037
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1821961194, enumerated as an "individual" on September 24, 2025.
The provider is located at 4601 S BROADWAY STE C LOS ANGELES, CA 90037 and the phone number is (213) 440-7448.
Rehabilitation Practitioner with taxonomy code 225400000X.
