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General NPI Number Information
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NPI Number | 1750316683
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Entity Type | Organization
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Legal Business Name | TRENTON E MOYER MD APC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 3252 HOLIDAY CT 102
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City | LA JOLLA
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State | CA
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Zip | 92037-0027
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Country | US
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Telephone | 858-457-1399
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Fax |
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Provider Business Mailing Address
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Address Line | 3252 HOLIDAY CT 102
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City | LA JOLLA
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State | CA
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Zip | 92037-0027
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Country | US
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Telephone | 858-457-1399
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TRENTON MOYER
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Credential | MD
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Telephone | 858-457-1399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A78165
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License Number State | CA
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