Individual
KIRK LEONARD MOON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G35183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G351830
—
CA
05
—
1295779833
—
NV
01
—
300130327
RAILROAD MEDICARE
CA
Enumeration date
06/15/2006
Last updated
05/05/2009
Update your record
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