Organization
MOONLIGHT MEDICAL CLINIC LLC
Active
Organization
MOONLIGHT MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE CODIE DIAMOND (OWNER)
(725) 207-4335
Entity
Organization
Contact information
Practice address
3556 TUNDRA SWAN ST, LAS VEGAS, NV 89122-3501
(725) 207-4335
Mailing address
3556 TUNDRA SWAN ST, LAS VEGAS, NV 89122-3501
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2025
Last updated
05/07/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up