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General NPI Number Information
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NPI Number | 1174756357
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Entity Type | Organization
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Legal Business Name | MOON M OH M D INC
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 3500 BARRANCA PKWY 330
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City | IRVINE
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State | CA
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Zip | 92606-8226
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Country | US
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Telephone | 949-552-8217
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Fax | 949-809-9514
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Provider Business Mailing Address
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Address Line | 3500 BARRANCA PKWY STE 330
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City | IRVINE
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State | CA
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Zip | 92606-8288
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Country | US
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Telephone | 949-552-8217
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Fax | 949-809-9514
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Authorized Official
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Title or Position | OWNER
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Name | MOON M OH
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Credential | MD
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Telephone | 949-552-8216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A107209
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License Number State | CA
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