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General NPI Number Information
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NPI Number | 1255485678
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Entity Type | Individual
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Provider Name | KAREN LIN MOODY DO
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 401 PINE ST # 4025
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City | SAINT LOUIS
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State | MO
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Zip | 63102-2731
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Country | US
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Telephone | 240-693-3281
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Fax |
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Provider Business Mailing Address
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Address Line | 401 WARREN ST STE 300
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City | REDWOOD CITY
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State | CA
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Zip | 94063-1536
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Country | US
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Telephone | 240-693-3281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2006000672
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License Number State | MO
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