Individual
DR. TIMOTHY H MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD 450
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49451801
—
HI
01
—
94-3274533
FEDERAL TAX ID
HI
01
—
A20813-0
HMSA QUEST
HI
Enumeration date
01/19/2007
Last updated
06/02/2026
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