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General NPI Number Information
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NPI Number | 1639525371
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Entity Type | Individual
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Provider Name | PATRICK JERRELL MOORE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 300 PASTEUR DR
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City | STANFORD
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State | CA
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Zip | 94305-2200
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Country | US
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Telephone | 650-736-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 EL CAMINO REAL UNIT 727
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City | REDWOOD CITY
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State | CA
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Zip | 94063-2136
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Country | US
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Telephone | 252-916-1431
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 036150357
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 78530
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036.150357
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.150357
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License Number State | IL
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