Tina Lee Moon, PA-C

NPI #1104946383 in San Dimas, California

Provider Information

NPI Number: 1104946383
Entity Type: Individual
Name: Tina Lee Moon, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 30, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1334 W COVINA BLVD
Address 2: SUITE 102
City: San Dimas
State: California
ZIP Code: 91773-3211
Phone: (909) 599-8677

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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