Moran, Mary Lynn

Moran, Mary Lynn is an sole proprietor health care provider with primary practice located at 2973 Woodside Rd , Woodside CA 94062-2443. She recently has only one registered license in Allopathic & Osteopathic Physicians / Facial Plastic Surgery, which is considered as her primary health care specialty. Moran, Mary Lynn can be contacted via phone (650) 851-0565.

Contact Information

Primary practice address
2973 Woodside Rd Woodside CA 94062-2443
Fax: (650) 851-0520
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X G-076828 California

Profile Details

NPI number 1417034877
LBN Legal business name Moran, Mary Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Jul 20th, 2020 - about 6 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 1417034877 NPPES
California MEDICAID 00G768280

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