Ji He Moon

Primary specialty

PharmacistTaxonomy code 183500000X

License

74396 Issued in CA

Practice address

406 N Main St
Sebastopol, CA 95472-3405

Phone

(707) 823-1037

NPI assigned

May 19, 2016

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

Other names 1

• Leah Moon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Safeway Inc

  • Community/Retail Pharmacy
  • Sebastopol, CA
  • NPI 1952347585
  NPD (past)
• Safeway Inc

  • Community/Retail Pharmacy
  • Queen Creek, AZ
  • NPI 1730040973
  NPD (past)

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1487001350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11424 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543602",
            "telephone_number": "909-518-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N MAIN ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723405",
            "telephone_number": "707-823-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JI HE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "74396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "MOON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Norman Jay Mintz, O.D.
• Asieh Moghaddam
• Conor Michael Moldowan, RPH
• Audrey Molony-Benjamin, CMT
• Michelle Montalbano
• Caroline Barrie Moore
• Tonnie Moore, PA
• Madeleine Carroll Morrison, N.D.
• Daniel David Morse, MFT
• Nikona Mulkovich, MFT

• Pharmacist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.