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Organization
MOYNIHAN FAMILY PRACTICE
Active
Organization
MOYNIHAN FAMILY PRACTICE
Active
Other names
Moynihan Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN M MOYNIHAN MD (OWNER/PRESIDENT/PHYSICIAN)
(530) 400-4880
Entity
Organization
Contact information
Practice address
6620 COYLE AVE STE 416, CARMICHAEL, CA 95608-6338
(530) 400-4880
Mailing address
PO BOX 632, DAVIS, CA 95617-0632
(530) 400-4880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G781610
—
CA
Enumeration date
11/22/2019
Last updated
11/22/2019
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