Provider Demographics
NPI:1467963199
Name:MOELLER, MICHAEL ERHARDT (ND)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ERHARDT
Last Name:MOELLER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2292 FARADAY AVE # 78
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7238
Mailing Address - Country:US
Mailing Address - Phone:949-485-4835
Mailing Address - Fax:818-459-3834
Practice Address - Street 1:2292 FARADAY AVE # 78
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7238
Practice Address - Country:US
Practice Address - Phone:949-485-4835
Practice Address - Fax:818-459-3834
Is Sole Proprietor?:No
Enumeration Date:2017-10-20
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA920175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF7296235OtherDRIVER'S LICENSE