Stan Mokoko, MD is a medicare enrolled "Family Medicine" in San Jacinto, California. His current practice location is
1695 S San Jacinto Ave Ste A, San Jacinto, California. You can reach out to his office (for appointments etc.) via phone at
(951) 330-3100.
Stan Mokoko is licensed to practice in Georgia (license number 102105) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1336994110.
Provider's Profile
Full Name | Stan Mokoko |
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Gender | Male |
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Speciality | Family Medicine |
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Location | 1695 S San Jacinto Ave Ste A, San Jacinto, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1336994110
- Provider Enumeration Date: 04/23/2024
- Last Update Date: 06/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 4789123902
- Enrollment ID: I20240830002619
Medical Identifiers
Medical identifiers for Stan Mokoko such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1336994110 | NPI | - | NPPES |
10004 | Other | CA | TEMP MSP PA LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 10004 (California) | Secondary |
363A00000X | Physician Assistant | 1983 (Puerto Rico) | Secondary |
207Q00000X | Family Medicine | 102105 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stan Mokoko is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Stan Mokoko, MD 36056 Darcy Pl, Murrieta, CA 92562-4563 Ph: (912) 272-4640 | Stan Mokoko, MD 1695 S San Jacinto Ave Ste A, San Jacinto, CA 92583-5103 Ph: (951) 330-3100 |
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