Pamela June Moore, RAD INTERN

Primary specialty

SpecialistTaxonomy code 174400000X

License

RS4253 Issued in CA

Practice address

15450 County Road 99
Woodland, CA 95695-9339

Phone

(530) 668-9627

Fax

(530) 668-8528

NPI assigned

Mar 16, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972627990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MATMOR RD",
            "address_2": "#169",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957765726",
            "telephone_number": "530-383-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 COUNTY ROAD 99",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956959339",
            "telephone_number": "530-668-9627",
            "fax_number": "530-668-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PAMELA",
        "middle_name": "JUNE",
        "name_prefix": "Mrs.",
        "credential": "RAD INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "RS4253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADI",
            "identifier": "RS4253",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary J Monroe-Rodman, MD
• Michael Phillip Montbriand
• Robert Mooney, P.T.
• Patricia L Moore-Pickett, MD
• Alyssa Shay Moore
• Efrain Morales
• Monique Morales
• Jasmin Alejandra Moreno-Iniguez, LVN
• Adilene Moreno
• Robyn Coleen Morris

• Specialist in Woodland, CA
• Providers in Woodland, CA by specialty
• Specialist 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.