MEDICARE: KELLY MOFF

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1063230514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY MOFF

Provider Business Mailing Address
First Line	:	240 EDMONDS RD., BUILDING D
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94062
Country	:	US
Telephone Number	:	650-209-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 EDMONDS RD., BUILDING D
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94062
Country	:	US
Telephone Number	:	650-209-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	06/07/2026

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Directions to “ KELLY MOFF ” Practice Location

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