Individual provider Active NPI

Manuel Luna, M.D.

  • Family Medicine Physician
  • South San Francisco, CA
National Provider Identifier
1700811601
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0C23460 Issued in CA
Practice address
161 S Spruce Ave
Suite B
South San Francisco, CA 94080-4517
Phone
(650) 871-5858
Fax
(650) 871-4834
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0C23460 CA Primary

Addresses

Primary practice location

161 S Spruce Ave
Suite B
South San Francisco, CA 94080-4517

Mailing address

161 S Spruce Ave
Suite B
South San Francisco, CA 94080-4517
Phone (650) 871-5858

Other identifiers 2

IdentifierTypeStateIssuer
00C234600MedicaidCA
PHY4155330MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0C23460CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
R.C. David Medical Corporation Past Accepting new patients
Palo Alto Medical Foundation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1700811601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 S SPRUCE AVE",
            "address_2": "SUITE B",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940804517",
            "telephone_number": "650-871-5858",
            "fax_number": "650-871-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 S SPRUCE AVE",
            "address_2": "SUITE B",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940804517",
            "telephone_number": "650-871-5858",
            "fax_number": "650-871-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "0C23460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C234600",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY4155330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.