MEDICARE: DR. MAYA M VAZIRANI M.D.

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	208000000X	Pediatrics Physician	A33369	CA
2	2080N0001X	Neonatal-Perinatal Medicine Physician	A33369	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	N96036	OTHER	CA	BLUE CROSS OF CA MEDI-CAL
2	953804947	OTHER		TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0101029195	OTHER	VA	PHYSICIAN &SURGEON
5	A33369	OTHER	CA	PHYSICIAN & SURGEON LICEN

General Provider Information

NPI Number	:	1932178456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYA M VAZIRANI M.D.

Provider Business Mailing Address
First Line	:	1717 W AVENUE J
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2703
Country	:	US
Telephone Number	:	661-945-6717
Fax Number	:	661-945-6718

Provider Business Practice Location Address
First Line	:	1717 W AVENUE J
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2703
Country	:	US
Telephone Number	:	661-945-6717
Fax Number	:	661-945-6718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	02/21/2012

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