Healthcare Provider Details

I. General information

NPI: 1346395100
Provider Name (Legal Business Name): MAULIK DILIPKUMAR MAJMUDAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17875 VON KARMAN AVE STE 150&250
IRVINE CA
92614-6200
US

IV. Provider business mailing address

75 FRANCIS ST
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 888-604-0014
  • Fax: 833-464-4177
Mailing address:
  • Phone: 617-732-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number238770
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2008-01159
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: