MR. PETER PAUL MUTYA BADUA NPI 1043036429

NPI Information

  • NPI: 1043036429
  • Provider Name: MR. PETER PAUL MUTYA BADUA
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10621 CHURCH ST STE 120
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Phone: (909) 944-0486

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NPI Details

MR. Peter Paul Mutya Badua is a family nurse practitioner in Rancho Cucamonga, CA with 2 years of experience. MR. Peter Paul Mutya Badua NPI is 1043036429. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10621 CHURCH ST STE 120
RANCHO CUCAMONGA, CA
ZIP 91730-834
Phone: (909) 944-0486

The NPI 1043036429 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/2/2024 and was last updated on 12/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily95030226CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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