Theresa Kyunghoi-Kim Moon, MD

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

A43482 Issued in CA

Practice address

2813 S Main St
Corona, CA 92882-5942

Phone

(951) 737-2962

Fax

(951) 737-2783

NPI assigned

Jun 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment NPD
• County of Riverside

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1407921356
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1477581270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18692 PATRICIAN DR",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614211",
            "telephone_number": "714-633-0184",
            "fax_number": "714-543-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825942",
            "telephone_number": "951-737-2962",
            "fax_number": "951-737-2783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1633 E 4th St",
            "address_2": "Ste. 380",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927015163",
            "country_code": "US",
            "telephone_number": "714-390-2673",
            "fax_number": "714-543-4488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "THERESA",
        "middle_name": "KYUNGHOI-KIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "A43482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Montez, BA
• Shilita Kay Montez
• Melanie Mooangprang
• Janice Lynn Moody, LCSW
• Moon G Yun MD, Inc
• Moonfield Medical MGMT. Corp
• April Kimberly Moore, RRW
• Ashleigh Marie Moore, NP
• Britney Kathleen Moore, LMFT M.A.
• Bryan L Moore

• Forensic Psychiatry Physician in Corona, CA
• Providers in Corona, CA by specialty
• Forensic Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.