Individual provider Active NPI

Michelle Moon, B.S., MAOM, L.AC.

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1447636741
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 16429 Issued in CA
Practice address
2425 Camino del Rio S Ste 150
San Diego, CA 92108-3770
Phone
(858) 212-6711
NPI assigned
Aug 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 16429 CA Primary

Addresses

Primary practice location

2425 Camino del Rio S Ste 150
San Diego, CA 92108-3770

Mailing address

13374 Greenstone CT
San Diego, CA 92131-4242

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
AC 16429CAMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1447636741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13374 GREENSTONE CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921314242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 CAMINO DEL RIO S STE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083770",
            "telephone_number": "858-212-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "MICHELLE",
        "credential": "B.S., MAOM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 16429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.