Active NPI
Gregory David Moon
- Internal Medicine Physician
- Palo Alto, CA
National Provider Identifier
1376058818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A063600
- Practice address
- 1843 Channing Ave
Palo Alto, CA 94303-3014 - Phone
- (650) 384-6543
- NPI assigned
- Dec 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A063600 | CA | Primary |
Addresses
Primary practice location
1843 Channing Ave
Palo Alto, CA 94303-3014
Mailing address
1843 Channing Ave
Palo Alto, CA 94303-3014
Phone (650) 384-6543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A063600 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512518400000",
"number": "1376058818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1843 CHANNING AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943033014",
"telephone_number": "650-384-6543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1843 CHANNING AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943033014",
"telephone_number": "650-384-6543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "GREGORY",
"middle_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-06",
"last_updated": "2017-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A063600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.