Hosam Moustafa, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A71010 Issued in CA

Practice address

301 W Bastanchury Rd Ste 130
Fullerton, CA 92835-3423

Phone

(714) 278-9363

Fax

(714) 278-9364

NPI assigned

Jun 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350
  Medicare reassignment NPD
• Broadway Imaging Medical Center

  • Diagnostic Radiology Physician
  • Glendale, CA
  • NPI 1497708002
  NPD Authorized official
• Advanced Imaging of South Bay, Inc.

  • Diagnostic Radiology Physician
  • Torrance, CA
  • NPI 1003866914
  NPD (past)
• Birch Radiology Associates, Inc.

  • Vascular & Interventional Radiology Physician
  • Newport Beach, CA
  • NPI 1891853941

  Diagnostic Radiology

  NPD (past)
• Memrad Medical Group Inc

  • Radiology Clinic/Center
  • Long Beach, CA
  • NPI 1831173905
  NPD (past)
• Pacific Coast Cardiology Medical Group

  • Cardiovascular Disease Physician
  • Newport Beach, CA
  • NPI 1245284843
  NPD (past)
• Medical Imaging Center LLP

  • Radiology Clinic/Center
  • East Syracuse, NY
  • NPI 1538153671
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1760418149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 130",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353423",
            "telephone_number": "714-278-9363",
            "fax_number": "714-278-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 130",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353423",
            "telephone_number": "714-278-9363",
            "fax_number": "714-278-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTAFA",
        "first_name": "HOSAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A71010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A710100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A710100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Isabel Mota
• Gaocha Mouanoutoua
• Sierra Moul
• Mountain Pass Wellness, a Nursing Corporation
• Taylor Paige Mountjoy, LCSW
• Movement Iq Physical Therapy, Inc
• Deirdre T Moxley, PA-C
• Tzu-Han Monica Mu, SLP, PA
• Vanessa Kigesa Mubarure
• Francisca Gabriela Mueller

• Diagnostic Radiology Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.