Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2012016765 | MO |
N | 111NI0900X | Internist | 2012016765 | MO |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 137429 | CA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 2012016765 | MO |
NPI | 1023339413 |
---|---|
Provider Name | Clare Moynihan |
First Address | Los Angeles, CA 90074-2244 |
Second Address | Emeryville, CA 94608-2016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2010 |
Last Update Date | 08/04/2017 |