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NPI Code Detail

MEDICARE: MS. L JOANNE MOONEY CNM

MEDICARE:  MS. L JOANNE MOONEY  CNM
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
1207V00000XObstetrics & Gynecology PhysicianNMW496CA
2367A00000XAdvanced Practice MidwifeNMW496CA

General Provider Information

NPI Number : 1801015193
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. L JOANNE MOONEY CNM
Provider Business Mailing Address
First Line : PO BOX 459
Second Line :
City : IMPERIAL BEACH
State : CA
Zip : 91933-0459
Country : US
Telephone Number : 619-429-3733
Fax Number :
Provider Business Practice Location Address
First Line : 1016 OUTER RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92154-1351
Country : US
Telephone Number : 619-429-3733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 01/31/2011

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Directions to “ MS. L JOANNE MOONEY CNM” Practice Location

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