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

Michael R. Moreno, MD

Individual provider Family Medicine Physician · NPI 1790837151

Michael R. Moreno, MD is a Family Practice in San Diego, California. Graduated from Hahnemann University College of Medicine in 1996, 30 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
30
Trained at
Hahnemann University College of Medicine
Licensed in
CA
In the registry since
2007
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

4647 Zion Ave
San Diego, CA 92120-2507
Phone: (619) 528-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A65119 (CA)

Record details

NPI number1790837151
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 17, 2007
Last updated in NPPESDecember 1, 2021

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolHAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Graduated 1996 (30 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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