Carlos Eduardo Maza, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A42083 Issued in CA

Practice address

117 West Bunny Avenue
Santa Maria, CA 93458-2805

Phone

(805) 739-3890

Fax

(805) 347-7697

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1063496651
  NPD (past)
• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1386793230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 PLAZA DRIVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546917",
            "telephone_number": "805-739-3890",
            "fax_number": "805-347-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 WEST BUNNY AVENUE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582805",
            "telephone_number": "805-739-3890",
            "fax_number": "805-347-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZA",
        "first_name": "CARLOS",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A42083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A42083",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Ross Egbert DC Inc
• Lara S Matty
• Maxim Healthcare Services
• Devin May
• Tami Marie Mayorga
• Chidalu Mbonu
• Staci Lynn-Sargent MC Lean, PT
• Krista Leigh McBride, RN
• Sabrina Mersadies McCammon
• Terri Ann McCarthy

• Family Medicine Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.