| Moynihan Family Practice | |
|
6620 Coyle Ave Ste 416 Carmichael CA 95608-6338 | |
| (530) 400-4880 | |
| Not Available |
| Full Name | Moynihan Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 6620 Coyle Ave Ste 416, Carmichael, California |
| Authorized Official Name and Position | Kevin M Moynihan (OWNER/PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 5304004880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moynihan Family Practice Po Box 632 Davis CA 95617-0632 Ph: (530) 400-4880 | Moynihan Family Practice 6620 Coyle Ave Ste 416 Carmichael CA 95608-6338 Ph: (530) 400-4880 |
| NPI Number | 1689210825 |
|---|---|
| Provider Enumeration Date | 11/22/2019 |
| Last Update Date | 11/22/2019 |
| Medicare PECOS PAC ID | 2961832332 |
|---|---|
| Medicare Enrollment ID | O20200427001149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689210825 | NPI | - | NPPES |
| 00G781610 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kevin Matthew Moynihan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982709028 PECOS PAC ID: 0446233506 Enrollment ID: I20040609001455 |
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