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NPI Code Detail

MEDICARE: KAYA MOORE PAC

MEDICARE: KAYA MOORE PAC
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
1363AM0700XMedical Physician AssistantPA18798CA

General Provider Information

NPI Number : 1659349785
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYA MOORE PAC
Provider Business Mailing Address
First Line : 325 DISTEL CIR
Second Line :
City : LOS ALTOS
State : CA
Zip : 94022-1408
Country : US
Telephone Number : 650-617-8100
Fax Number : 650-327-2947
Provider Business Practice Location Address
First Line : 1950 UNIVERSITY AVE
Second Line : 160
City : EAST PALO ALTO
State : CA
Zip : 94303-2250
Country : US
Telephone Number : 650-617-8100
Fax Number : 650-327-2947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 06/26/2020

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Directions to “ KAYA MOORE PAC” Practice Location

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