Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | A126422 | CA |
NPI | 1295029775 |
---|---|
Provider Name | Judy Moon |
First Address | San Francisco, CA 94143-2208 |
Second Address | Loma Linda, CA 92354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2011 |
Last Update Date | 30/07/2018 |