Individual provider Active NPI

Moosa M Lunat, M.D.

  • Pediatrics Physician
  • Manteca, CA
National Provider Identifier
1265493217
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A32534 Issued in CA
Practice address
1191 E Yosemite Ave
Suite B
Manteca, CA 95336-5011
Phone
(209) 823-8158
Fax
(209) 823-6186
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A32534 CA Primary

Addresses

Primary practice location

1191 E Yosemite Ave
Suite B
Manteca, CA 95336-5011

Mailing address

1191 E Yosemite Ave
Suite B
Manteca, CA 95336-5011
Phone (209) 823-8158

Other identifiers 1

IdentifierTypeStateIssuer
A32534MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A32534CAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1265493217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 E YOSEMITE AVE",
            "address_2": "SUITE B",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365011",
            "telephone_number": "209-823-8158",
            "fax_number": "209-823-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 E YOSEMITE AVE",
            "address_2": "SUITE B",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365011",
            "telephone_number": "209-823-8158",
            "fax_number": "209-823-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNAT",
        "first_name": "MOOSA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A32534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A32534",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.