Ibrahim Mulic

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA57956 Issued in CA

Practice address

1742 Oregon St
Redding, CA 96001-1717

Phone

(619) 228-4717

NPI assigned

Apr 15, 2020

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

Medicare fee-for-service enrollment

Enrolled in CA, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Physician Assistant

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.

• Happy Sol Medical PC

  • Neurology Physician
  • San Diego, CA
  • NPI 1861272973
  Medicare reassignment Authorized official
• East Point Medical PC

  • Family Medicine Physician
  • Maspeth, NY
  • NPI 1518571751
  Medicare reassignment NPD

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1992324321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6254 CAMINITO ANDRETA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921117203",
            "telephone_number": "619-228-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 OREGON ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011717",
            "telephone_number": "619-228-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULIC",
        "first_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Touzhong Mua
• Lauren Mueller, PA-C
• Steven E Mueller, D.C.
• Omar Idris Mufti, MD
• Tiara T Muhr, RN, FNP-BC
• Netanya M Mullen, DO
• Thomas W. Mullen, D.D.S.
• Cynthia Marie Muncy, LVN
• Jonathan Munns
• Audrey Elizabeth Munson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.