Moon, Michael

Moon, Michael is an sole proprietor health care provider with primary practice located at 5348 Carroll Canyon Rd Suite 101, San Diego CA 92121-1733. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Moon, Michael can be contacted via phone (858) 202-1546.

Contact Information

Primary practice address
5348 Carroll Canyon Rd Suite 101 San Diego CA 92121-1733
Phone: (858) 202-1546
Fax: (858) 202-1548
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X A61865 California

Profile Details

NPI number 1619014230
LBN Legal business name Moon, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2007
Last updated Sep 24th, 2012 - about 12 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619014230 NPPES
California MEDICAID GR0096070
California Other ZZZ07215Z
California Other A61865
California Other 127169100
California Other 330992123
California Other P00302519

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