NPIMap

Organization Active NPI

Moutaz Almawaldi MD PC

  • Nephrology Physician
  • Lakeport, CA
National Provider Identifier
1164600896
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A49796 Issued in CA
Legal business name
MOUTAZ ALMAWALDI MD PC
Practice address
5120 Hill Rd E
Lakeport, CA 95453-6300
Phone
(707) 263-4766
Fax
(707) 263-4771
NPI assigned
Feb 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Mohamad Moutaz Almawaldi, M.D.
Title
Ceo/Owner
Phone
(707) 263-4766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X A49796 CA Primary

Addresses

Primary practice location

5120 Hill Rd E
Lakeport, CA 95453-6300

Mailing address

5120 Hill Rd E
PO Box 1917
Lakeport, CA 95453-6300
Phone (707) 263-4766

Other names 1

  • MOUTAZ ALMAWALDI,M.D. A PROFESSIONAL CORPORATION Other name

National Provider Directory

National Provider Directory

Locations

5120 Hill Rd E
Lakeport, CA 95453
Phone (707) 263-3433

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1164600896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 HILL RD E",
            "address_2": "PO BOX 1917",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-263-4766",
            "fax_number": "707-263-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-263-4766",
            "fax_number": "707-263-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUTAZ ALMAWALDI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ALMAWALDI",
        "authorized_official_first_name": "MOHAMAD MOUTAZ",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "707-263-4766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A49796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUTAZ ALMAWALDI,M.D. A PROFESSIONAL CORPORATION",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakeport, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.