CLARA HWANG MOON , NPI 1326451022 — VALENCIA (CA)

NPI 1326451022

5+ Years Experience Organization

CLARA HWANG MOON

06.10.2014
PROVIDER ENUMERATION DATE
06.10.2014
LAST UPDATE DATE
1326451022
NPI NUMBER

About CLARA HWANG MOON

CLARA HWANG MOON is a provider established in VALENCIA, CA. The NPI number of CLARA HWANG MOON is 1326451022 and was assigned on 06.10.2014. The practitioners primary taxonomy code is: 174400000X with license number: OT 6012 CA .

Mailing address

  • City: VALENCIA
  • State: CA
  • Postal code: 913554023
  • Phone: 6612950181
  • Fax: 6612959776
  • Address: 28093 SMYTH DR

Primary Practice Address

  • Region : VALENCIA, CA
  • NPI : 1326451022
  • Phone : 6612950181
  • Fax : 6612959776
  • Postalcode : 913554023
  • Address : 28093 SMYTH DR

Provider taxonomy - Specialist

  • Taxonomy code: 174400000X
  • License number: OT 6012
  • License state: CA

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193200000X MULTI-SPECIALTY GROUP.

Taxonomy description: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Contacts:

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  • CLARA HWANG MOON
  • Address : 28093 SMYTH DR
  • Region : VALENCIA, CA
  • NPI : 1326451022
  • Phone : 6612950181
  • Fax : 6612959776
  • Postalcode : 913554023

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 6612950181
  • Title or position : ADMINISTRATOR
  • Credentials : B.A.

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address28093 SMYTH DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameVALENCIA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code913554023
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6612950181
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6612959776
The fax number associated with the location address of the provider being identified.
NPI1326451022
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Provider Enumeration Date06.10.2014
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated06.10.2014
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)CLARA HWANG MOON
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address28093 SMYTH DR
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameVALENCIA
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code913554023
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6612950181
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6612959776
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameKEEHNE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameCHERYL
The first name of the authorized official
Authorized Official Middle NameCOLEEN
The middle name of the authorized official
Authorized Official Title or PositionADMINISTRATOR
The title or position of the authorized official
Authorized Official Credential TextB.A.
Authorized Official Credential Text
Authorized Official Telephone Number6612950181
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1174400000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Provider License Number 1OT 6012
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1CA
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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