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

Mr. Kenzie Jamal Moore, IDC

Individual provider Independent Duty Corpsman · NPI 1932542636

Mr. Kenzie Jamal Moore, IDC is an Independent Duty Corpsman in Los Angeles, California. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

5954 Edgemar Ave
Los Angeles, CA 90043-3452
Phone: (323) 559-1541
Show map & directions

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

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1932542636
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorYes
NPI enumeratedApril 11, 2013
Last updated in NPPESApril 11, 2013

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