Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A108369 | CA |
Y | 2080P0208X | Pediatric Infectious Diseases | A108369 | CA |
NPI | 1104023670 |
---|---|
Provider Name | Dr. Amaran Moodley |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 03/01/2019 |