Organization
YOUNGSIK MOON, M.D., P.A.
Active
Other names
Hollywood Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTY ANN QUADE (BUSINESS MANAGER)
(301) 373-2116
Entity
Organization
Contact information
Practice address
24435 MERVELL DEAN RD, HOLLYWOOD, MD 20636-2712
(301) 373-2116
(301) 373-5281
Mailing address
PO BOX 37, HOLLYWOOD, MD 20636-0037
(301) 373-2116
(301) 373-5281
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1200
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008273
CIGNA
—
01
—
029J
CAREFIRST
MD
01
—
199904-02
AMERIGROUP
—
01
—
2134736
AETNA HMO
—
01
—
250800
MAMSI
—
01
—
5108771
AETNA
—
01
—
5607239
FIRST HEALTH/CCN
—
01
—
57494301
CAREFIRST
MD
01
—
PL8
CAREFIRST
DC
Enumeration date
08/19/2006
Last updated
08/22/2020
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