Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A126952 | CA |
NPI | 1528266202 |
---|---|
Provider Name | Dr. Ryan E Moore |
First Address | Saint Helena, CA 94574-9501 |
Second Address | Saint Helena, CA 94574 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 02/08/2019 |