Individual provider Active NPI

Stan Ekume Mokoko Sr., MD

  • Family Medicine Physician
  • Temecula, CA
National Provider Identifier
1336994110
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
102105 Issued in GA
Practice address
43300 Business Park Dr Ste A105
Temecula, CA 92590-3649
Phone
(833) 262-2185
Fax
(877) 353-8605
NPI assigned
Apr 23, 2024
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 102105 GA Primary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 102105 GA

Addresses

Primary practice location

43300 Business Park Dr Ste A105
Temecula, CA 92590-3649

Mailing address

36056 Darcy PL
Murrieta, CA 92562-4563
Phone (912) 272-4640

Other practice location 1

163 Willow Oak Drive
Richmond Hill, GA 31324
Phone (833) 262-2185

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240830002619 CA Practitioner - Physician Assistant 4789123902 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
102105GAMDBehavioral Neurology & Neuropsychiatry Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1336994110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36056 DARCY PL",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624563",
            "telephone_number": "912-272-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43300 BUSINESS PARK DR STE A105",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903649",
            "telephone_number": "833-262-2185",
            "fax_number": "877-353-8605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "163 Willow Oak Drive",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "GA",
            "postal_code": "31324",
            "country_code": "US",
            "telephone_number": "833-262-2185",
            "fax_number": "877-353-8605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOKOKO",
        "first_name": "STAN",
        "middle_name": "EKUME",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-23",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "102105",
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "GA",
            "license": "102105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.