Moon, Lisa Elaine
Moon, Lisa Elaine is an sole proprietor health care provider with primary practice located at 360 Sierra College Dr Suite 100, Grass Valley CA 95945-5088. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Moon, Lisa Elaine can be contacted via phone (530) 273-3190.Contact Information
Primary practice address
360 Sierra College Dr Suite 100
Grass Valley CA 95945-5088
Phone: (530) 273-3190
Fax: (530) 273-5541
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 6088T | California |
Profile Details
| NPI number | 1174592869 |
|---|---|
| LBN Legal business name | Moon, Lisa Elaine |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 15th, 2006 |
| Last updated | Jun 15th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174592869 | NPPES |
| Other | YYY49206Y | GROUP MEDICARE PIN | |
| MEDICAID | YYY49206Y | GROUP MEDICARE PIN | |
| Other | 0366860001 | GROUP MEDICARE PIN |
Popular Providers
-
Woodburn, Kevin Dlyn
400 Sierra College Dr. Suite A, Grass Valley CA 95945 -
Ota, Gordon Kiyoshi
10130 Warner Ave Suite J, Fountain Valley CA 92708-1619 -
Borsky, Tomas
154 Hughes Rd Suite 3, Grass Valley CA 95945-5630 -
Stallings, Harriet G.
10130 Warner Ave Suite J, Fountain Valley CA 92708-1619 -
Thomas, Lizabeth Paulino
400 Sierra College Dr Ste A , Grass Valley CA 95945-5093 -
Shields, William Samuel
2812 Cochran St , Simi Valley CA 93065-2780 -
Munoz, Joel
360 Sierra College Dr Ste 100 , Grass Valley CA 95945-5088 -
Hagele, James
400 Sierra College Drive Suite A, Grass Valley CA 95945-5089