Individual provider Active NPI

George L. Mayo, M.D.

  • Ophthalmology Physician
  • Garden Grove, CA
National Provider Identifier
1265591994
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G83501 Issued in CA
Practice address
12665 Garden Grove Blvd Ste 300
Garden Grove, CA 92843-1917
Phone
(657) 667-0817
Fax
(657) 667-0819
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G83501 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 300
Garden Grove, CA 92843-1917

Mailing address

12665 Garden Grove Blvd Ste 300
Garden Grove, CA 92843-1917
Phone (657) 667-0817

Other identifiers 1

IdentifierTypeStateIssuer
WG83501AOtherCAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000698 CA Practitioner - Ophthalmology 8729158969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Perelman School of Med at the University of Pennsylvania, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12665 Garden Grove Blvd
Suite 300
Garden Grove, CA 92843-1917
Phone (657) 667-0817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G83501CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Retina, Inc. CurrentSince May 1, 2008 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

16543 Brookhurst St
Fountain Valley, CA 92708
Phone (714) 418-9749

12665 Garden Grove Blvd
Ste 300
Garden Grove, CA 92843
Phone (657) 667-0817

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768003200000",
    "number": "1265591994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 300",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "657-667-0817",
            "fax_number": "657-667-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 300",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "657-667-0817",
            "fax_number": "657-667-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "GEORGE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G83501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "WG83501A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.