Individual provider Active NPI

Toby Lustig, MD

  • Pediatrics Physician
  • Walnut Creek, CA
National Provider Identifier
1336177336
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G80520 Issued in CA
Practice address
1822 San Miguel Drive
Walnut Creek, CA 94596
Phone
(925) 945-3850
Fax
(925) 934-0471
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 G80520 CA Primary

Addresses

Primary practice location

1822 San Miguel Drive
Walnut Creek, CA 94596

Mailing address

1822 San Miguel Drive
Walnut Creek, CA 94596
Phone (925) 945-3850

Other names 1

  • Emil T Lustig Professional name

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
G80520CAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336177336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 SAN MIGUEL DRIVE",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94596",
            "telephone_number": "925-945-3850",
            "fax_number": "925-934-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 SAN MIGUEL DRIVE",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94596",
            "telephone_number": "925-945-3850",
            "fax_number": "925-934-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "TOBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G80520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMIL",
            "last_name": "LUSTIG",
            "middle_name": "T",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.