Individual
PAUL OH SUNG MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1810 E 19TH ST STE 225, THE DALLES, OR 97058-3388
(541) 296-6101
(541) 296-0025
Mailing address
1810 E 19TH ST STE 225, THE DALLES, OR 97058-3388
(541) 296-6101
(541) 296-0025
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD18425
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056940
—
OR
05
—
8149056
—
WA
Enumeration date
07/14/2006
Last updated
03/29/2016
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