Provider Demographics
NPI:1740501378
Name:MOON, NAH YONG (MD)
Entity type:Individual
Prefix:
First Name:NAH YONG
Middle Name:
Last Name:MOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 E VALLEY PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3373
Mailing Address - Country:US
Mailing Address - Phone:760-745-7060
Mailing Address - Fax:760-294-7784
Practice Address - Street 1:488 E VALLEY PKWY STE 310
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3373
Practice Address - Country:US
Practice Address - Phone:760-745-7060
Practice Address - Fax:760-294-7784
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98573207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology