Individual provider Active NPI

Marilyn Mulay, RN, NP

  • Licensed Practical Nurse
  • Santa Monica, CA
National Provider Identifier
1487779377
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
NP 16738 Issued in CA
Practice address
Premiere Oncology
2020 Santa Monica Blvd
Santa Monica, CA 90404
Phone
(310) 633-8400
Fax
(310) 633-8419
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X RN 496453 CA
Licensed Practical Nurse 164W00000X NP 16738 CA Primary

Addresses

Primary practice location

Premiere Oncology
2020 Santa Monica Blvd
Santa Monica, CA 90404

Mailing address

12412 Texas Ave
Unit 206
Los Angeles, CA 90025-1963
Phone (310) 571-0084

Other identifiers 1

IdentifierTypeStateIssuer
NP 16738OtherCANURSE PRACTIONER LIC

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
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 496453CAMDOncology Registered Nurse
NP 16738CAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1487779377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12412 TEXAS AVE",
            "address_2": "UNIT 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251963",
            "telephone_number": "310-571-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PREMIERE ONCOLOGY",
            "address_2": "2020 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-633-8400",
            "fax_number": "310-633-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULAY",
        "first_name": "MARILYN",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "CA",
            "license": "RN 496453",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "NP 16738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTIONER LIC",
            "identifier": "NP 16738",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.