Provider Demographics
NPI:1487801304
Name:MAYA B KAURA M D INC
Entity type:Organization
Organization Name:MAYA B KAURA M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:BIDICHANDANI
Authorized Official - Last Name:KAURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-248-5884
Mailing Address - Street 1:24865 DEL PRADO
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2853
Mailing Address - Country:US
Mailing Address - Phone:949-248-5884
Mailing Address - Fax:949-248-5886
Practice Address - Street 1:24865 DEL PRADO
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2853
Practice Address - Country:US
Practice Address - Phone:949-248-5884
Practice Address - Fax:949-248-5886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41651174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA61149Medicare UPIN