Provider Demographics
NPI:1720148505
Name:MOY, BRAD K (MD)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:K
Last Name:MOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1199 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5999
Mailing Address - Country:US
Mailing Address - Phone:415-353-6305
Mailing Address - Fax:415-353-6527
Practice Address - Street 1:1199 BUSH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5999
Practice Address - Country:US
Practice Address - Phone:415-353-6305
Practice Address - Fax:415-353-6527
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG58202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine