Active NPI
Su Mai, M.D.
- Facial Plastic Surgery Physician
- Garden Grove, CA
National Provider Identifier
1376883975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Facial Plastic Surgery Physician
- License
- A033477
- Practice address
- 13071 Brookhurst St Ste 150
Garden Grove, CA 92843-1024 - Phone
- (714) 530-3340
- Fax
- (714) 530-3345
- NPI assigned
- Feb 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | A033477 | CA | Primary |
Addresses
Primary practice location
13071 Brookhurst St Ste 150
Garden Grove, CA 92843-1024
Mailing address
13071 Brookhurst St Ste 150
Garden Grove, CA 92843-1024
Phone (714) 530-3340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A033477 | CA | MD | Facial Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361318400000",
"number": "1376883975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13071 BROOKHURST ST STE 150",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431024",
"telephone_number": "714-530-3340",
"fax_number": "714-530-3345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13071 BROOKHURST ST STE 150",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431024",
"telephone_number": "714-530-3340",
"fax_number": "714-530-3345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAI",
"first_name": "SU",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-20",
"last_updated": "2013-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207YS0123X",
"taxonomy_group": "",
"desc": "Otolaryngology, Facial Plastic Surgery",
"state": "CA",
"license": "A033477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.