1841452950 NPI number — DR. ERIN GREENSPUN MOORE MD

Table of content: DR. ERIN GREENSPUN MOORE MD (NPI 1841452950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841452950 NPI number — DR. ERIN GREENSPUN MOORE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOORE
Provider First Name:
ERIN
Provider Middle Name:
GREENSPUN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GREENSPUN
Provider Other First Name:
ERIN
Provider Other Middle Name:
MICHELE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841452950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BUILDING 588 M/C 7002
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93106-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-893-5361
Provider Business Mailing Address Fax Number:
805-893-4111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BUILDING 588 M/C 7002 UCSB STUDENT HEALTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93106-4339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-893-3371
Provider Business Practice Location Address Fax Number:
805-893-4911
Provider Enumeration Date:
06/30/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A11819 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)