Individual
DR. MOON IP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4300 CRENSHAW BLVD, LOS ANGELES, CA 90008-4902
(323) 298-1000
(323) 298-0458
Mailing address
4300 CRENSHAW BLVD, LOS ANGELES, CA 90008-4902
(323) 298-1000
(323) 298-0458
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A35407
CA
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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