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NPI Code Detail

MEDICARE: JONG YEOUNG MOON M.D

MEDICARE: JONG YEOUNG MOON 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
1207R00000XInternal Medicine PhysicianC52501CA

General Provider Information

NPI Number : 1598753956
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONG YEOUNG MOON M.D
Provider Business Mailing Address
First Line : 24511 WEST JAYNE AVE P.O BOX 5002
Second Line :
City : COALINGA
State : CA
Zip : 93210-5002
Country : US
Telephone Number : 559-935-4300
Fax Number :
Provider Business Practice Location Address
First Line : 24511 W JAYNE AVE
Second Line :
City : COALINGA
State : CA
Zip : 93210-9503
Country : US
Telephone Number : 559-935-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 10/23/2015

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Directions to “ JONG YEOUNG MOON M.D” Practice Location

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