Antonio Zamboanga Luza, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10062 Issued in CA

Practice address

2951 Fulton Ave
Sacramento, CA 95821-4909

Phone

(916) 486-7555

Fax

(916) 486-7557

NPI assigned

Jan 9, 2006

Last updated

Sep 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Janak K. Mehtani

  dba Fair Oaks Psychiatric Associates

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1194879056
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1891773834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 FULTON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214909",
            "telephone_number": "916-486-7555",
            "fax_number": "916-486-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 FULTON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214909",
            "telephone_number": "916-486-7555",
            "fax_number": "916-486-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUZA",
        "first_name": "ANTONIO",
        "middle_name": "ZAMBOANGA",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "10062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "10062",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vickie@thefopa.com",
            "affiliation": "N",
            "endpointDescription": "Admin email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2951 Fulton Ave",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958214909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• James Jeffrey Luz, MD
• Luzminda C Corpuz DMD Inc
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• Yee May Lwin
• Xiamy Ly-Yang
• Amy Tran Ly

• Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.