Individual
SANDRA MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3810 WILSHIRE BLVD APT 2211, #2211, LOS ANGELES, CA 90010-3230
(310) 729-7785
Mailing address
3810 WILSHIRE BLVD APT 2211, #2211, LOS ANGELES, CA 90010-3230
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95001140
CA
Other
Enumeration date
07/27/2015
Last updated
02/10/2022
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