David Mawad, FNP- C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021560 Issued in CA

Practice address

10459 Mountain View Ave
Loma Linda, CA 92354-2033

Phone

(909) 801-7077

NPI assigned

Jan 24, 2022

Reactivated

Jun 8, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1104578848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15861 SQUARE TOP LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364587",
            "telephone_number": "347-790-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10459 MOUNTAIN VIEW AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542033",
            "telephone_number": "909-801-7077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Western Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924111356",
            "country_code": "US",
            "telephone_number": "909-474-9952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16465 Sierra Lakes Pkwy Ste 245",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923361267",
            "country_code": "US",
            "telephone_number": "909-350-3003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAWAD",
        "first_name": "DAVID",
        "credential": "FNP- C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-07-06",
        "certification_date": "2022-06-17",
        "deactivation_date": "2022-05-19",
        "reactivation_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95170178",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Kenneth Mattheis, M.D.
• Rosemary Ann Matthess, PHYSICAL THERAPY
• Christina Marie Mattle, NP
• Allie Ann Maus, AU.D.
• John Charlie Maveli, DDS
• Anne Kristin Maxwell, M.D.
• Jacob Paul Maxwell, RN, DNP
• Kenneth L Maxwell II, D.O.
• William N. May, M.D.
• Cesar Maya

• Family Nurse Practitioner in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.