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NPI Code Detail

MEDICARE: DR. TONI CECILIA MOODY M.D.

MEDICARE: DR. TONI CECILIA MOODY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianG89178CA
2208000000XPediatrics PhysicianME72512FL
3208000000XPediatrics Physician34405GA

General Provider Information

NPI Number : 1083792477
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TONI CECILIA MOODY M.D.
Provider Business Mailing Address
First Line : 1860 HOWE AVE STE 440
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-1098
Country : US
Telephone Number : 916-569-8484
Fax Number :
Provider Business Practice Location Address
First Line : 4815 WATT AVE
Second Line :
City : NORTH HIGHLANDS
State : CA
Zip : 95660-5108
Country : US
Telephone Number : 916-454-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/27/2023

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