Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Madison Moore

Individual provider Physician Assistant · NPI 1558119560

Madison Moore is a Physician Assistant in San Diego, California. Licensed in California and Illinois. Registered with an NPI since 2024.

Licensed in
CA, IL
In the registry since
2024
Specialties on file
2

Practice location Address checks out

4420 Hotel Circle Ct Ste 200
San Diego, CA 92108-3423
Phone: (619) 933-2165
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA68382 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 085011506 (IL)

Record details

NPI number1558119560
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 7, 2024
Last updated in NPPESMay 15, 2026
Certification dateMay 15, 2026

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