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General NPI Number Information
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NPI Number | 1134048283
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Entity Type | Organization
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Legal Business Name | MOON PEDIATRIC THERAPY INC.
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 9760 LITTLE CANYON LN
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City | ESCONDIDO
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State | CA
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Zip | 92026
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Country | US
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Telephone | 619-925-6795
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 6TH AVE STE 550
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City | SAN DIEGO
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State | CA
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Zip | 92101-5211
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | ISAIAH RAMOS
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Credential |
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Telephone | 951-500-2964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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