Active NPI
Rayburn Mubita Mumbuna
- Pharmacist
- Hesperia, CA
National Provider Identifier
1710603956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH86790
- Practice address
- 17383 Main St
Hesperia, CA 92345-6111 - Phone
- (760) 948-0481
- NPI assigned
- Oct 19, 2022
- Last updated
- Oct 19, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH86790 | CA | Primary |
Addresses
Primary practice location
17383 Main St
Hesperia, CA 92345-6111
Mailing address
17383 Main St
Hesperia, CA 92345-6111
Phone (760) 948-0481
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH86790 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, 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": "1666137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1710603956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17383 MAIN ST",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923456111",
"telephone_number": "760-948-0481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17383 MAIN ST",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923456111",
"telephone_number": "760-948-0481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUMBUNA",
"first_name": "RAYBURN",
"middle_name": "MUBITA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-19",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH86790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.