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General NPI Number Information
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NPI Number | 1356305866
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Entity Type | Individual
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Provider Name | JOHN MAA MD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 250 BON AIR RD
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City | GREENBRAE
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State | CA
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Zip | 94904-1702
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Country | US
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Telephone | 415-924-2515
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Fax | 415-924-2661
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Provider Business Mailing Address
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Address Line | 5 BON AIR ROAD #101
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City | LARKSPUR
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State | CA
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Zip | 94909
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Country | US
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Telephone | 415-924-2515
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Fax | 415-924-2661
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A55909
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License Number State | CA
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