Mary Lou Lao David, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

18743 Issued in CA

Practice address

22 Bluff Cove Dr
Aliso Viejo, CA 92656-8077

Phone

(949) 360-0587

NPI assigned

Jun 19, 2009

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350
  Medicare reassignment NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760
  NPD (past)
• Vanguard Geriatrics Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Houston, TX
  • NPI 1356300420
  NPD (past)
• Vanguard Geriatrics of Texas Inc

  • Primary Care Nurse Practitioner
  • Houston, TX
  • NPI 1801129515

  Family

  NPD (past)

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1245467992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 BARRANCA PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926047706",
            "telephone_number": "949-551-1090",
            "fax_number": "949-262-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BLUFF COVE DR",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926568077",
            "telephone_number": "949-360-0587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "MARY LOU",
        "middle_name": "LAO",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "18743",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Damiano, M.A., B.C.B.A.
• Jasmine Daniel, BCBA, LMFT
• Zachariah Daum, PHARM.D
• Jacqueline Daut, BCBA
• Bernadette Franco David, RN
• Virginia Lapira David, D.D.S.
• Aline De Carvalho Franca
• Alycia De Lucio, RN
• Claudia Patricia Del Valle, OTR
• Nicole Delehanty, NP

• Primary Care Nurse Practitioner in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.