Healthcare Provider Details

I. General information

NPI: 1437844198
Provider Name (Legal Business Name): EUGENE MOON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD
PHOENIX AZ
85013-4496
US

IV. Provider business mailing address

16220 N SCOTTSDALE RD STE 600
SCOTTSDALE AZ
85254-1804
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3000
  • Fax:
Mailing address:
  • Phone: 480-306-6949
  • Fax: 602-302-5706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number74254
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: