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Organization

MICHAEL MOON MD A MEDICAL CORPORATION

Active
Other names
PainCare of San Diego, AMC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL MOON M.D. (CEO)
(858) 202-1546
Entity
Organization

Contact information

Practice address
5348 CARROLL CANYON RD, SUITE 101, SAN DIEGO, CA 92121-1733
(858) 202-1546
(858) 202-1548
Mailing address
5348 CARROLL CANYON RD, SUITE 101, SAN DIEGO, CA 92121-1733
(858) 202-1546
(858) 202-1548

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
A61865
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
127169100
US DEPARTMENT OF LABOR
CA
05
GR009670
CA
01
ZZZ07215Z
BLUE SHIELD
CA
Enumeration date
05/23/2006
Last updated
06/14/2022
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