Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A54430 | CA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A54430 | CA |
NPI | 1700981685 |
---|---|
Provider Name | Richard J Mooney |
First Address | Redding, CA 96001-3027 |
Second Address | Redding, CA 96001-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 12/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0094810 | (05) | CA |