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MOON M OH M D INC
NPI 1174756357
Family Medicine in Irvine, CA

Active since September 03, 2009CLIA 05D2000460 · Waiver
3500 BARRANCA PKWY, 330, IRVINE, CA 92606(949) 552-8217(949) 809-9514 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Moon M Oh M D Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOON M OH M D INC (NPI 1174756357), doing business as Irvine Professional Medical Group, is a healthcare organization registered as a family medicine in Irvine, California and active in the NPI registry since September 2009. The organization holds a CLIA Waiver certificate valid through November 30, 2027 and lists Moon M Oh, Owner, as its authorized official.

NPPES Registry Identity

NPI1174756357
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMOON M OH M D INC
Location Address3500 BARRANCA PKWY, 330Irvine, CA 92606-8226
Mailing Address3500 Barranca Pkwy Ste 330Irvine, CA 92606-8288 · (949) 552-8217 · Fax (949) 809-9514
Phone(949) 552-8217
Fax(949) 809-9514
Organization SubpartNo
Authorized OfficialMoon M OhOwner · (949) 552-8216
Enumeration DateSeptember 3, 2009
Last NPPES UpdateOctober 21, 2025
NPPES CertifiedOctober 21, 2025
✔ NPI 1174756357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A107209
Definition
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.
3500 BARRANCA PKWY, Irvine, CA 92606
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Other Names 2

Doing Business AsIrvine Professional Medical Group
Other NameMoon M. Oh Md, Inc

Other Identifiers 1

OtherA107209CA · Medical Board Of California

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moon M Oh M D Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Moon M Oh M D Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Moon Mock Oh, M.D.
Family Practice
NPI 1902838881
3500 BARRANCA PKWY STE 330
Irvine, CA 92606
(949) 552-8217
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2000460

Moon M. Oh, MD, Inc. · Irvine, CA
Active · expires Nov 30, 2027
CLIA Number05D2000460
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorMoon M. Oh, MD
Laboratory Phone(949) 552-8217
Laboratory LocationMoon M. Oh, MD, Inc.3500 Barranca Pkwy Ste 330, Irvine, CA 92606
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moon M Oh M D Inc's NPI number?

The NPI number for Moon M Oh M D Inc is 1174756357. It was assigned to this organization in the NPPES registry on September 3, 2009. The provider is doing business as Irvine Professional Medical Group. The provider is also known as Moon M. Oh MD, Inc.

Where is Moon M Oh M D Inc located?

Moon M Oh M D Inc is located at 3500 Barranca Pkwy 330, Irvine, CA 92606. The listed phone number is (949) 552-8217.

What is Moon M Oh M D Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Moon M Oh M D Inc enrolled in Medicare?

Yes. Moon M Oh M D Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Moon M Oh M D Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Moon M Oh M D Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Moon M Oh M D Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2000460) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Moon M Oh M D Inc was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.