Healthcare Provider Details

I. General information

NPI: 1831313337
Provider Name (Legal Business Name): RONALD K MOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3865 JACKSON ST
RIVERSIDE CA
92503-3919
US

IV. Provider business mailing address

32 GARDENPATH
IRVINE CA
92603-0156
US

V. Phone/Fax

Practice location:
  • Phone: 951-898-0823
  • Fax: 951-898-0821
Mailing address:
  • Phone: 949-679-1906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA98832
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: