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Individual

DR. MARY LYNN MORAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2973 WOODSIDE RD, WOODSIDE, CA 94062-2443
(650) 851-0565
(650) 851-0520
Mailing address
600A FRAZIER DR STE 120, FRANKLIN, TN 37067-4670
(615) 224-8387

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
G-076828
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G768280
CA
Enumeration date
11/01/2006
Last updated
09/11/2025
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