Individual
JEAN M MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1840 S STAPLEY DR, SUITE 131, MESA, AZ 85204-6681
(480) 969-5999
(480) 926-0852
Mailing address
1840 S STAPLEY DR, SUITE 131, MESA, AZ 85204-6681
(480) 969-5999
(480) 926-0852
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20256
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136441
AHCCCS
AZ
01
—
1Z1315
HEALTH NET
AZ
01
—
919828
AETNA
AZ
01
—
AZ0344420
BLUE CROSS BLUE SHIELD
AZ
01
—
ZWCLFM04
MEDICARE
AZ
Enumeration date
04/06/2006
Last updated
07/27/2016
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