Individual provider Active NPI

Paul John Magat Buan

  • Primary Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1275177149
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95012159 Issued in CA
Practice address
1039 W Florence Ave
Los Angeles, CA 90044-2441
Phone
(323) 776-1500
NPI assigned
Nov 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95012159 CA Primary

Addresses

Primary practice location

1039 W Florence Ave
Los Angeles, CA 90044-2441

Mailing address

1039 W Florence Ave
Los Angeles, CA 90044-2441
Phone (323) 776-1500

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

State licenses

LicenseStateTypeSpecialty
95012159CAMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1275177149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 W FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900442441",
            "telephone_number": "323-776-1500",
            "fax_number": "855-777-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 W FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900442441",
            "telephone_number": "323-776-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUAN",
        "first_name": "PAUL JOHN",
        "middle_name": "MAGAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95012159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.