Koala Bear Moore, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC11779 Issued in CA

Practice address

2346 Stuart St
Berkeley, CA 94705-1109

Phone

(510) 705-8755

Fax

(510) 705-8520

NPI assigned

May 17, 2007

Sex

Male

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

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.

• On Point Acupuncture, Inc.-

  • Primary Care Clinic/Center
  • Berkeley, CA
  • NPI 1619022761
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881801660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 59TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091570",
            "telephone_number": "510-393-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 STUART ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051109",
            "telephone_number": "510-705-8755",
            "fax_number": "510-705-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KOALA",
        "middle_name": "BEAR",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Moore, PSY.D
• Anna Moore, ASW
• Caroline Moore, PH.D., LCSW
• Ellen Moore, LCSW
• Emily Lorraine Fisher Moore, NP, RN
• Teresa Mary Moore, MS, NCC
• Heather Chandler Moorhead, MSW
• Kierra Michelle Moorhead
• Walter Douglas Moorhead, M.D.
• Lorenzo Mora

• Acupuncturist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.