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General NPI Number Information
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NPI Number | 1518001114
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Entity Type | Organization
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Legal Business Name | MAPARA MEDICAL GROUP, INC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 5475 E. LA PALMA AVE SUITE 100
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City | ANAHEIM
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State | CA
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Zip | 92807-2075
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Country | US
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Telephone | 714-970-0911
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Fax | 714-970-0604
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Provider Business Mailing Address
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Address Line | 5475 E. LA PALMA AVE SUITE 100
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City | ANAHEIM
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State | CA
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Zip | 92807-2075
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Country | US
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Telephone | 714-970-0911
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Fax | 714-970-0604
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Authorized Official
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Title or Position | ADMNISTRATOR
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Name | KALPNA MAPARA
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Credential |
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Telephone | 714-970-0911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A28448
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A78248
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A37744
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License Number State | CA
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