Provider Demographics
NPI:1467486076
Name:MOY, RONALD LEONARD (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:LEONARD
Last Name:MOY
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:421 N RODEO DR
Mailing Address - Street 2:2ND FLOOR, TERRACE LEVEL
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4500
Mailing Address - Country:US
Mailing Address - Phone:310-274-5372
Mailing Address - Fax:310-274-5380
Practice Address - Street 1:421 N RODEO DR
Practice Address - Street 2:2ND FLOOR, TERRACE LEVEL
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4500
Practice Address - Country:US
Practice Address - Phone:310-274-5372
Practice Address - Fax:310-274-5380
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG48489207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG48489AMedicare PIN
CAA51077Medicare UPIN