MARK MOELLER (NPI# 1457508608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457508608 |
| Entity Type | Individual |
| Full Name | MARK MOELLER |
| Credential | M.D. |
| Practice Address |
2020 Sutter Pl Suite 101 Davis CA 95616-6213 |
| Mailing Address |
Po Box 255228 Sacramento CA 95865-5228 |
| Practice Telephone | 5307505830 |
| Mailing Telephone | 8004700071 |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2009-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A106182 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083895510 | Mark Steven Moeller | Dentist | 1836 South Ave, La Crosse, WI 54601-5429 | 2007-11-27 |
| 1053590133 | Mark S Moeller | Psychiatry & Neurology | 6300 West Loop S, Suite 680, Bellaire, TX 77401-2900 | 2007-10-25 |
| 1194870592 | Mark R Moeller | Physical Therapist | 2015 Sidewinder Dr, Park City, UT 84060-7323 | 2007-01-24 |
| 1336126416 | Mark Steven Moeller | Emergency Medicine | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2005-12-29 |
| 1053304097 | Mark B Moeller | Internal Medicine | 137 Medical Lane, Pollocksville, NC 28573 | 2005-08-24 |
| Street Address |
2020 SUTTER PL SUITE 101 |
| City | DAVIS |
| State | CA |
| Zip Code | 95616-6213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467428656 | Michael S Petersen | Orthopaedic Surgery | 2020 Sutter Pl, Suite 104, Davis, CA 95616-6213 | 2006-02-27 |
| 1841706140 | Eric Bailey | Specialist/Technologist | 2020 Sutter Pl, Davis, CA 95616-6213 | 2017-12-21 |
| 1366835670 | Alexa Christine Smith-ellison | Nurse Practitioner | 2020 Sutter Pl, 203, Davis, CA 95616-6213 | 2015-03-11 |
| 1467844969 | Eric Westgate Kinsey | Physician Assistant | 2020 Sutter Pl, 101, Davis, CA 95616-6213 | 2015-02-20 |
| 1720345895 | David Posner | Family Medicine | 2020 Sutter Pl, Suite 101, Davis, CA 95616-6213 | 2012-04-13 |
| 1487942728 | Amparo M Cerda | Registered Nurse | 2020 Sutter Pl, Ste 101, Davis, CA 95616-6213 | 2011-07-20 |
| 1043442650 | Scott Mcintosh Porter | Orthopaedic Surgery | 2020 Sutter Pl, Suite 104, Davis, CA 95616-6213 | 2009-08-14 |
| 1174764187 | Jessica Lynn Witty Nagel | Advanced Practice Midwife | 2020 Sutter Pl, Suite 203, Davis, CA 95616-6213 | 2009-03-20 |
| 1396924874 | Sarah Joan Markley | Pediatrics | 2020 Sutter Pl, Davis, CA 95616-6213 | 2007-10-31 |
| 1972793446 | Danielle Marie Franzi-mcclure | Specialist/Technologist | 2020 Sutter Pl, 104, Davis, CA 95616-6213 | 2007-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560871 | Anne-frances Ostrander | Physical Therapy Assistant | 397 La Rue Rd, Davis, CA 95616 | 2020-08-26 |
| 1487271458 | Alix Peloso Mahon | Behavior Technician | 1212 Alvarado Ave Apt 68, Davis, CA 95616 | 2020-06-25 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 1871126961 | Linda Marie Adams | Dietitian, Registered | Uc Davis Occupational Health, One Shields Ave - Cowell Hall Room 35, Davis, CA 95616 | 2020-02-17 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1386290716 | Dakota Cool | Specialist/Technologist | 750 Orchard Road, Davis, CA 95616 | 2019-08-12 |
| 1366908618 | Capitol Periodontal Group | Dentist | 750 F Street #5, Davis, CA 95616 | 2019-02-12 |
| 1831663434 | Elisha Niccole Cusumano | Specialist/Technologist | 264 Hickey Gym, 1 Shields Ave, Davis, CA 95616 | 2019-01-16 |
| 1609364991 | Aron Matthew Katz | Psychologist | One Shield Ave, Student Health & Wellness Center, Bhp, Davis, CA 95616 | 2018-04-23 |
| 1316463938 | Arielle Pinkston | Marriage & Family Therapist | 203 F St, Davis, CA 95616 | 2017-08-15 |
| Find all providers in zip 95616 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871029611 | Ana Lopez-vera | Family Medicine | 1112 Eagle Pl, Davis, CA 95616-5700 | 2017-05-11 |
| 1609285584 | Sharon Amon | Family Medicine | 2408 Elendil Ln, Davis, CA 95616-3044 | 2014-08-05 |
| 1558646513 | Pin-chieh Chiang | Family Medicine | 216 F Street, Ste141, Davis, CA 95616 | 2011-10-20 |
| 1265734925 | David K Leung | Family Medicine | 638 Coolidge St, Davis, CA 95616-3064 | 2010-11-30 |
| 1477648921 | Jeffrey Kraig Katzenmeyer | Family Medicine | 2020 Sutter Place, #101, Davis, CA 95616 | 2006-10-03 |
| 1710094529 | Rupert J.o. Visaya | Family Medicine | 3435 Verona Ter, Davis, CA 95618-6724 | 2006-08-25 |
| 1730294448 | Kenneth C Clay | Family Medicine | 2660 W Covell Blvd Ste C, Davis, CA 95616-5645 | 2006-08-20 |
| 1689602773 | Mark P Ewens | Family Medicine | 2330 W. Covell Blvd, Davis, CA 95616-5058 | 2006-06-29 |
| 1568498319 | Thomas W Ormiston | Family Medicine | 2330 W Covell Blvd, Davis, CA 95616-5658 | 2006-06-23 |
| 1306882030 | Sarah Sallee Jones | Family Medicine | 2030 Sutter Place, #2000, Davis, CA 95616 | 2006-06-21 |
| Find all providers in DAVIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.