Dianna Mung-Fung Mak, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A5237 Issued in CA

Practice address

9089 Baseline Road
Suite 100
Rancho Cucamonga, CA 91730

Phone

(909) 483-0505

Fax

(909) 483-0508

NPI assigned

Aug 30, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inland Physicians Service IncGroup PAC ID 2769386093, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inland Physicians Service Inc

  dba Inland Region Medical Group

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1083724850
  Medicare reassignment Care Compare group
• Prime Healthcare Services - Montclair, LLC

  dba Montclair Hopsital Medical Center

  • General Acute Care Hospital
  • Montclair, CA
  • NPI 1992721161
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1104936988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9089 BASELINE ROAD",
            "address_2": "SUITE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-483-0505",
            "fax_number": "909-483-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9089 BASELINE ROAD",
            "address_2": "SUITE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-483-0505",
            "fax_number": "909-483-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "DIANNA",
        "middle_name": "MUNG-FUNG",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00148996",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX52370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maher Azzawi DDS Inc.
• Maher Azzawi DDS LLC
• Elise Mahill
• Colin Mahler
• Brian Patrick Mahorney, B.C.B.A.
• Karen Mak, D.D.S.
• Robert Maki, ND
• Making Life Wonderful (MLW), Inc
• Hetalben Makwana, MD
• Zozimo R Malana

• Family Medicine Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.