Active NPI
Muaj Lo, MD
- Family Medicine Physician
- Fort Bragg, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C206263
- Practice address
- 205 South St
Fort Bragg, CA 95437-5540 - Phone
- (707) 964-1251
- Fax
- (707) 961-2722
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C206263 | CA | Primary |
| Family Medicine Physician | 207Q00000X | 54717 | MN | |
| Family Medicine Physician | 207Q00000X | 47517 | WI |
Addresses
Primary practice location
205 South St
Fort Bragg, CA 95437-5540
Mailing address
205 South St
Fort Bragg, CA 95437-5540
Phone (707) 964-1251
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34607100 | Medicaid | WI |
Other names 1
- Moua Vang
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Side Community Health Services, Inc.
Practice addresses (Care Compare)
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone (651) 602-7500
1544 Timberlake Rd
Saint Paul, MN 55117-3946
Phone (651) 602-7500
8325 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5868
8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5300
8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148
895 7TH St E
Saint Paul, MN 55106-3871
Phone (651) 602-7500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C206263 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health, Inc. | Current | Accepting new patients | |
| West Side Community Health Services, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| West Side Community Health Services, Inc. | Current | Accepting new patients | |
| West Side Community Health Services, Inc. | Current | Accepting new patients | |
| Group Health Plan, Inc. | Current | Accepting new patients | |
| Mendocino Coast Clinics Inc | Past | Accepting new patients |
Locations
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
1544 Timberlake Rd
Saint Paul, MN 55117
Phone (651) 558-2191
153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816
Interoperability endpoints
- mlo733115@direct.ochin.org
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 8
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.
-
dba HealthPartners Medical Group
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
dba McDonough Homes Clinic
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1821149964
-
- Federally Qualified Health Center (FQHC)
- Fort Bragg, CA
- NPI 1609595404
-
dba HealthPartners Well@Work-Anoka County
- Health Service Clinic/Center
- Anoka, MN
- NPI 1962704346
-
dba HealthPartners Midway Residency Dental
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
-
dba MINNESOTA COMMUNITY CARE MBC - St. Paul
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1043187289
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1699809939
-
- Federally Qualified Health Center (FQHC)
- Fort Bragg, CA
- NPI 1083783757
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mendocino Coast District Hospital
- Critical Access Hospital
- Fort Bragg, CA
- NPI 1538113725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1487644985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 SOUTH ST",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954375540",
"telephone_number": "707-964-1251",
"fax_number": "707-961-2722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 SOUTH ST",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954375540",
"telephone_number": "707-964-1251",
"fax_number": "707-961-2722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LO",
"first_name": "MUAJ",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C206263",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "54717",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "47517",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34607100",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MOUA",
"last_name": "VANG",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fort Bragg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.