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

Mary Moreno, MD

Individual provider Family Medicine Physician · NPI 1033420252

Mary Moreno, MD is a Family Practice in Fairfield, California. Graduated from University of Southern California Keck School of Medicine in 2010, 16 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and New Hampshire.

Years since qualifying
16
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA, NH
In the registry since
2010
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone: (707) 646-5000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2500 Alhambra Ave, Martinez, CA 94553-3156 — (925) 370-5110

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A126876 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence RT-2119 (NH)

Record details

NPI number1033420252
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 23, 2010
Last updated in NPPESDecember 17, 2021
Mailing address2642 Harrison St, Oakland, CA 94612-3814

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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