Provider Demographics
NPI:1538358197
Name:MOORE, YUN-PING (OD)
Entity type:Individual
Prefix:DR
First Name:YUN-PING
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1515 CALIBRE WOODS DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3963
Mailing Address - Country:US
Mailing Address - Phone:781-866-9705
Mailing Address - Fax:
Practice Address - Street 1:771 OLD NORCROSS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4386
Practice Address - Country:US
Practice Address - Phone:770-995-5408
Practice Address - Fax:770-513-2042
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002613152W00000X
MO2007032272152W00000X
MA4685152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist