Individual
DR. MICHAEL P. MULDOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3750 CONVOY ST, SUITE 201, SAN DIEGO, CA 92111-3738
(858) 278-8300
(858) 278-1708
Mailing address
3750 CONVOY ST, SUITE 201, SAN DIEGO, CA 92111-3738
(858) 278-8300
(858) 278-1708
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G70877
CA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
G70877
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G708770
—
CA
Enumeration date
11/01/2006
Last updated
02/04/2014
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