MICHAEL MOON MD A MEDICAL (NPI# 1629023387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629023387 |
| Entity Type | Organization |
| Organization Name | MICHAEL MOON MD A MEDICAL |
| Other Organization Name | PAINCARE OF SAN DIEGO, AMC |
| Practice Address |
5348 Carroll Canyon Rd Suite 101 San Diego CA 92121-1733 |
| Practice Telephone | 8582021546 |
| Practice Fax Number | 8582021548 |
| Mailing Telephone | 8582021546 |
| Mailing Fax Number | 8582021548 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | DR. MICHAEL MOON (CEO) |
| Authorized Official Telephone | 8582021546 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
A61865 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | US DEPARTMENT OF LABOR | 127169100 | 01 |
| CA | BLUE SHIELD | ZZZ07215Z | 01 |
| CA | GR009670 | 05 |
| Other Name | Type Code |
|---|---|
| PainCare of San Diego, AMC | Doing Business As Name - Organization |
| Street Address |
5348 CARROLL CANYON RD SUITE 101 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497160337 | Center for Integrative Wellness: A Cbt Psychological Corporation | Psychologist | 5348 Carroll Canyon Rd, Suite 101, San Diego, CA 92121-1733 | 2014-06-30 |
| 1972844140 | Function Fit Rehab | Health Educator | 5348 Carroll Canyon Rd, Suite 101, San Diego, CA 92121-1733 | 2013-03-12 |
| 1154559730 | Sabina Sehgal | Psychologist | 5348 Carroll Canyon Rd, Suite 101, San Diego, CA 92121-1733 | 2009-06-23 |
| 1619157658 | David C Majors | Physical Medicine & Rehabilitation | 5348 Carroll Canyon Rd, Suite 101, San Diego, CA 92121-1733 | 2007-11-07 |
| 1619014230 | Michael Moon | Pain Medicine | 5348 Carroll Canyon Rd, Suite 101, San Diego, CA 92121-1733 | 2007-01-31 |
| 1629189857 | Danny Song | Chiropractor | 5348 Carroll Canyon Rd, Suite 101, San Diego, CA 92121-1733 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679031611 | Jesus H. Lao Md Inc | Physical Medicine & Rehabilitation | 6699 Alvarado Rd Ste 2304, San Diego, CA 92120-5241 | 2019-03-08 |
| 1326203605 | Daniel Maxwell Stuart | Physical Medicine & Rehabilitation | 4510 Executive Dr Ste 100, San Diego, CA 92121-3022 | 2008-07-25 |
| 1407052459 | Henry Able Richardson | Physical Medicine & Rehabilitation | 7525 Metropolitan Dr Ste 302, San Diego, CA 92108-4404 | 2007-06-26 |
| 1649290891 | John Xiao-jiang Qian | Physical Medicine & Rehabilitation | 5395 Ruffin Road., Ste. 204, San Diego, CA 92123-1338 | 2006-07-20 |
| 1518957521 | Walter William Strauser | Physical Medicine & Rehabilitation | 2999 Health Center Dr, San Diego, CA 92123-2762 | 2005-10-21 |
| 1326031980 | Alan Bruce Hurschman | Physical Medicine & Rehabilitation | 5395 Ruffin Rd Ste 204, San Diego, CA 92123-1338 | 2005-08-29 |
| 1205838448 | Howard Jay Waldman | Physical Medicine & Rehabilitation | 5252 Balboa Ave, Ste 901, San Diego, CA 92117-6906 | 2005-06-01 |
| 1356795157 | Pain Allevia Medical Corporation | Physical Medicine & Rehabilitation | 16466 Bernardo Center Dr, Suite 150, San Diego, CA 92128-2522 | 2016-04-18 |
| 1700296514 | Joel Castellanos | Physical Medicine & Rehabilitation | 200 W Arbor Dr, San Diego, CA 92103 | 2014-05-01 |
| 1326464660 | Saiyun Hou | Physical Medicine & Rehabilitation | 5395 Ruffin Rd Ste 204, San Diego, CA 92123-1338 | 2014-03-11 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.