MEDICARE: MAISON MEDICAL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1841958840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAISON MEDICAL INC.

Provider Business Mailing Address
First Line	:	132 SKY HTS
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92602-1877
Country	:	US
Telephone Number	:	614-906-4627
Fax Number	:

Provider Business Practice Location Address
First Line	:	7617 LITTLE RIVER TPKE STE 710
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-2635
Country	:	US
Telephone Number	:	614-906-4627
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	DR. ANAND NILAKANTAN
Credential	:	DO
Telephone Number	:	614-906-4627

Provider Enumeration Date	:	12/07/2021
Last Update Date	:	03/31/2022

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