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General NPI Number Information
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NPI Number | 1538358197
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Entity Type | Individual
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Provider Name | YUN-PING MOORE O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/19/2007
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 771 OLD NORCROSS RD SUITE 150
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4386
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Country | US
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Telephone | 770-995-5408
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Fax | 770-513-2042
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Provider Business Mailing Address
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Address Line | 1515 CALIBRE WOODS DR NE
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City | ATLANTA
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State | GA
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Zip | 30329-3963
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Country | US
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Telephone | 781-866-9705
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002613
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2007032272
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4685
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License Number State | MA
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