=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699604066
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUMINA SURGICAL GYNECOLOGY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2026
-----------------------------------------------------
Last Update Date | 05/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1910 S STAPLEY DR STE 120
-----------------------------------------------------
City | MESA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85204-6676
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-744-1518
-----------------------------------------------------
Fax | 602-584-4120
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8722 E LAUREL ST
-----------------------------------------------------
City | MESA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85207-3021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-722-4179
-----------------------------------------------------
Fax | 602-584-4120
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JAMAL MOURAD
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 602-722-4179
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------