DR. THEODORE HYUNSUB MOON M.D. NPI 1568438455

NPI Information

NPI: 1568438455
Provider Name: DR. THEODORE HYUNSUB MOON, M.D.
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

PECOS Registration: Yes

Address:
1380 E MEDICAL CENTER DR
SUITE 2200
ST GEORGE, UT
ZIP 84790
Phone: (435) 251-2600
Get Directions

DR. Theodore Hyunsub Moon, M.D. is a pulmonary disease internal medicine in St George, UT with 30 years of experience. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. DR. Theodore Hyunsub Moon, M.D. NPI is 1568438455. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1994

The provider's business location address is:

1380 E MEDICAL CENTER DR
SUITE 2200
ST GEORGE, UT
ZIP 84790-123
Phone: (435) 251-2600
Fax: (435) 251-2610

The NPI 1568438455 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/28/2006 and was last updated on 8/2/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0200X	Internal Medicine	Critical Care Medicine	A60692	CALIFORNIA	No
2	207RP1001X	Internal Medicine	Pulmonary Disease	A60692	CALIFORNIA	No
3	207RC0200X	Internal Medicine	Critical Care Medicine	8288624-8017	UTAH	No
4	207RP1001X	Internal Medicine	Pulmonary Disease	8288624-8017	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A606920	MEDICAID	CALIFORNIA
2	W481	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE GROUP NUMBER
3	H52941	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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