DR. ELIOT MOON (NPI# 1821153743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821153743 |
| Entity Type | Individual |
| Full Name | DR. ELIOT MOON |
| Credential | M.D. |
| Practice Address |
940 Avenue 64 Pasadena CA 91105 |
| Practice Telephone | 3232542274 |
| Practice Fax Number | 3232549087 |
| Mailing Telephone | 3232542274 |
| Mailing Fax Number | 3232549087 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2013-07-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
G79762 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
G79762 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770047128 | Eliot Moon | Behavior Technician | 23151 Verdugo Dr Ste 113, Laguna Hills, CA 92653-1340 | 2019-01-29 |
| Street Address |
940 AVENUE 64 |
| City | PASADENA |
| State | CA |
| Zip Code | 91105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790860039 | Robert R. Howard | Social Worker | 940 Avenue 64, Pasadena, CA 91105-2711 | 2006-10-26 |
| 1225639453 | Cinnamon Raykel Mccellen | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-11-04 |
| 1285234401 | Paulette Koss | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-10-27 |
| 1497355614 | Taqwa Ramadan | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-10-27 |
| 1801496013 | Tiffany Rose Garcia | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-10-27 |
| 1518566728 | Courtney Bre'ann Oaties | Licensed Vocational Nurse | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-10-19 |
| 1598364713 | Anna Darlene Roberts | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-10-19 |
| 1861009078 | Bianca J Russell | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-09-30 |
| 1609483817 | Estephany Olivos | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-09-30 |
| 1417564626 | Raul Carreon | Rehabilitation Practitioner | 940 Avenue 64, Pasadena, CA 91105-2711 | 2020-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245457407 | Laurance Folkey Johnson | Psychiatry & Neurology | 2810 E. Del Mar Bivd., Suite 7, Pasadena, CA 91107 | 2007-04-19 |
| 1932401791 | Francisco Navarro | Psychiatry & Neurology | 940 Avenue 64, Pasadena, CA 91105-2711 | 2010-11-30 |
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| 1043848872 | Nelson Md and Lochhead Md, A Professional Medical Corporation | Psychiatry & Neurology | 28202 Cabot Rd Ste 635, Laguna Niguel, CA 92677-1222 | 2020-03-28 |
| 1003455460 | Ranvinder Kaur Rai Md | Psychiatry & Neurology | 39676 Mission Blvd, Fremont, CA 94539-3000 | 2020-01-03 |
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| 1275190068 | Allan S Abrams Md Inc | Psychiatry & Neurology | 4726 Winnetka Ave, Woodland Hills, CA 91364-4737 | 2019-05-28 |
| 1225527427 | Better Life Therapy, Inc. | Psychiatry & Neurology | 9520 Escondido Canyon Rd, Santa Clarita, CA 91390-4811 | 2018-05-03 |
| 1821515099 | J. Kirk Hartman, M.d. | Psychiatry & Neurology | 3860 Blackhawk Rd # 120, Danville, CA 94506-4905 | 2017-08-28 |
| 1912432055 | Centered Health LLC | Psychiatry & Neurology | 6422 W 6th St, Los Angeles, CA 90048-4714 | 2017-04-26 |
| 1255871182 | Carol R Harrus | Psychiatry & Neurology | 517 Patricia Ln, Palo Alto, CA 94303-2856 | 2017-02-25 |
| 1437539509 | Ehab Yacoub, Md Inc. | Psychiatry & Neurology | 1225 W 190th St Ste 470, Gardena, CA 90248-4316 | 2015-06-04 |
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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.