Moon, Theodore Hyunsub

Moon, Theodore Hyunsub is an individual health care provider with primary practice located at 1380 E Medical Center Dr Suite 2200, St George UT 84790-2123. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Moon, Theodore Hyunsub can be contacted via phone (435) 251-2600.

Contact Information

Primary practice address
1380 E Medical Center Dr Suite 2200 St George UT 84790-2123
Phone: (435) 251-2600
Fax: (435) 251-2610
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X A60692 California
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X A60692 California
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 8288624-8017 Utah
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 8288624-8017 Utah

Profile Details

NPI number 1568438455
LBN Legal business name Moon, Theodore Hyunsub
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Aug 2nd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568438455 NPPES
California MEDICAID 00A606920

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