MR. KENZIE JAMAL MOORE IDC
NPI 1932542636
Military Health Care Provider - Independent Duty Corpsman in Los Angeles, CA

Q: What is Kenzie Moore's NPI number?

The NPI number for Kenzie Moore is 1932542636. It was assigned to this individual provider in the NPPES registry on April 11, 2013.

Q: What is Kenzie Moore's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Kenzie Moore was last updated on April 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 11, 2013

5954 EDGEMAR AVE, LOS ANGELES, CA 90043(323) 559-1541 Get Directions Write a Review

NPPES record last updated: April 11, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Kenzie Jamal Moore Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KENZIE JAMAL MOORE IDC (NPI 1932542636) is an individual independent duty corpsman provider in Los Angeles, California and active in the NPI registry since April 2013.

NPPES Registry Identity

NPI1932542636

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. KENZIE JAMAL MOORECredential: IDC

Location Address5954 EDGEMAR AVELos Angeles, CA 90043-3452

Mailing Address5954 Edgemar AveLos Angeles, CA 90043-3452 · (323) 559-1541

Phone(323) 559-1541

Sole ProprietorYes

Enumeration DateApril 11, 2013

✔ NPI 1932542636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

5954 EDGEMAR AVE, Los Angeles, CA 90043

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenzie Moore's NPI number?

The NPI number for Kenzie Moore is 1932542636. It was assigned to this individual provider in the NPPES registry on April 11, 2013.

Where is Kenzie Moore located?

Kenzie Moore practices at 5954 Edgemar Ave, Los Angeles, CA 90043. The listed phone number is (323) 559-1541.

What is Kenzie Moore's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Kenzie Moore was last updated on April 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.