Healthcare Provider Details

I. General information

NPI: 1366512451
Provider Name (Legal Business Name): MARICELA MAFFEY LUJAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARICELA MAFFEY-GUZMAN MD

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W SANTA ANA BLVD STE 100
SANTA ANA CA
92701-4134
US

IV. Provider business mailing address

200 W SANTA ANA BLVD STE 100
SANTA ANA CA
92701-4134
US

V. Phone/Fax

Practice location:
  • Phone: 714-347-0469
  • Fax: 714-347-0301
Mailing address:
  • Phone: 714-347-0469
  • Fax: 714-347-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG072526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: