Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marc Andrew Moreno

Individual provider Physical Therapist · NPI 1629750815

Marc Andrew Moreno is a Physical Therapist in Private Practice in Van Nuys, California. Qualified in 2023, 3 years ago. Practices with All Star Physical Therapy, a 150-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
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Practice location Address checks out

16300 Roscoe Blvd Ste A1
Van Nuys, CA 91406-1246
Phone: (818) 893-4426
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 304495 (CA)

Record details

NPI number1629750815
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 7, 2023
Last updated in NPPESAugust 7, 2023
Certification dateAugust 6, 2023
Mailing address20323 Gresham St, Winnetka, CA 91306-1122

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice All Star Physical Therapy — 150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Van Nuys