Individual
DR. CHARLES MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8700 BEVERLY BLVD., LOS ANGELES, CA 90048-1865
(310) 423-9954
(310) 423-9470
Mailing address
PO BOX 512717, LOS ANGELES, CA 90051-0717
(310) 423-9954
(310) 423-9470
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A63715
CA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
A63715
CA
Other
Enumeration date
12/02/2005
Last updated
08/08/2014
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