Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | PSY8045 | CA |
NPI | 1376602219 |
---|---|
Provider Name | Dr. James Paul Moran |
First Address | Redwood City, CA 94063-2612 |
Second Address | Redwood City, CA 94063-2612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |