Individual provider Active NPI

Joseph Nunokawa

  • Physician Assistant
  • La Mirada, CA
National Provider Identifier
1114682366
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60793 Issued in CA
Practice address
16000 Grayville Dr Unit 65
La Mirada, CA 90638-2602
Phone
(714) 345-6693
NPI assigned
Nov 2, 2021
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60793 CA Primary

Addresses

Primary practice location

16000 Grayville Dr Unit 65
La Mirada, CA 90638-2602

Mailing address

5842 Kingman Ave Apt 2
Buena Park, CA 90621-2006
Phone (147) 345-6693

Other practice location 1

5842 Kingman Ave Apt 2
Buena Park, CA 90621-2006
Phone (147) 345-6693

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405000426 CA Practitioner - Physician Assistant 9335535178 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60793CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinu-Clear Inc CurrentSince Nov 15, 2025 Accepting new patients

Locations

9620 Fremont Ave
Montclair, CA 91763
Phone (909) 227-0750

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1114682366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5842 KINGMAN AVE APT 2",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212006",
            "telephone_number": "147-345-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 GRAYVILLE DR UNIT 65",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382602",
            "telephone_number": "714-345-6693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5842 Kingman Ave Apt 2",
            "address_purpose": "LOCATION",
            "city": "Buena Park",
            "state": "CA",
            "postal_code": "906212006",
            "country_code": "US",
            "telephone_number": "147-345-6693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUNOKAWA",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.