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NPI Code Detail

MEDICARE: MARJANEH MOINI MD

MEDICARE:   MARJANEH  MOINI  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology PhysicianA65359CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200A653591OTHERCABLUE SHIELD

General Provider Information

NPI Number : 1023009438
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJANEH MOINI MD
Provider Business Mailing Address
First Line : 4301 NORTHSTAR WAY
Second Line :
City : MODESTO
State : CA
Zip : 95356-9262
Country : US
Telephone Number : 209-342-2300
Fax Number : 209-524-4240
Provider Business Practice Location Address
First Line : 2540 EAST ST
Second Line :
City : CONCORD
State : CA
Zip : 94520-1906
Country : US
Telephone Number : 209-342-2300
Fax Number : 209-524-4240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 12/08/2008

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Directions to “ MARJANEH MOINI MD” Practice Location

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