Provider Demographics
NPI:1477742906
Name:MOORE, DAVID FRANCIS (MD, PHD, FAAN)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FRANCIS
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD, PHD, FAAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 FOLSOM BLVD STE 2100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5266
Mailing Address - Country:US
Mailing Address - Phone:816-734-3588
Mailing Address - Fax:916-451-2009
Practice Address - Street 1:3160 FOLSOM BLVD STE 2100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5266
Practice Address - Country:US
Practice Address - Phone:916-734-3588
Practice Address - Fax:916-451-2009
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00541512084N0400X, 2084V0102X, 2084V0102X
MN646272084N0400X
FLME1608792084N0400X, 2084V0102X
TXP23072084V0102X
CAC1526172084N0400X
LAMD.2043842084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302137001Medicaid
TXTXB155007Medicare PIN