# YOUNGSIK MOON, M.D., P.A.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Hollywood Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245447465
- **Authorized official:** MS. BETTY ANN QUADE (BUSINESS MANAGER)
- **Authorized official phone:** (301) 373-2116

## Contact information

- **Practice address:** 24435 MERVELL DEAN RD, HOLLYWOOD, MD 20636-2712
- **Practice address phone:** (301) 373-2116
- **Practice address fax:** (301) 373-5281
- **Mailing address:** 24435 MERVELL DEAN RD, PO BOX 37, HOLLYWOOD, MD 20636-2712
- **Mailing address phone:** (301) 373-2116
- **Mailing address fax:** (301) 373-5281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208600000X | Surgery Physician | D09178 | MD | — |
| 208D00000X | General Practice Physician | D09178 | MD | — |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 03/24/2011