# MICHAEL MOON MD A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PainCare of San Diego, AMC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629023387
- **Authorized official:** DR. MICHAEL MOON M.D. (CEO)
- **Authorized official phone:** (858) 202-1546

## Contact information

- **Practice address:** 5348 CARROLL CANYON RD, SUITE 101, SAN DIEGO, CA 92121-1733
- **Practice address phone:** (858) 202-1546
- **Practice address fax:** (858) 202-1548
- **Mailing address:** 5348 CARROLL CANYON RD, SUITE 101, SAN DIEGO, CA 92121-1733
- **Mailing address phone:** (858) 202-1546
- **Mailing address fax:** (858) 202-1548

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | A61865 | CA | Yes |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 06/14/2022