Lul Musaid Taher Bubak, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86103497 Issued in CA

Practice address

1915 High St
Selma, CA 93662-3510

Phone

(559) 352-5242

NPI assigned

Jan 19, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1043962210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 MILL ST",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936624602",
            "telephone_number": "559-352-5242",
            "fax_number": "559-891-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 HIGH ST",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623510",
            "telephone_number": "559-352-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHER BUBAK",
        "first_name": "LUL",
        "middle_name": "MUSAID",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86103497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Selma, CA
• Providers in Selma, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.