NPIMap

Organization Active NPI

Kelvin Mai, D.O., Inc

  • Primary Care Clinic/Center
  • Santa Ana, CA
National Provider Identifier
1437485513
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
20A8944 Issued in CA
Legal business name
KELVIN MAI, D.O., INC
Practice address
1002 N Fairview St
Santa Ana, CA 92703-1811
Phone
(714) 332-1069
NPI assigned
Oct 26, 2009
Last updated
Sep 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Sandra Orantes
Title
Credentialing Manager
Phone
(310) 515-5004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 20A8944 CA Primary

Addresses

Primary practice location

1002 N Fairview St
Santa Ana, CA 92703-1811

Mailing address

1002 N Fairview St
Santa Ana, CA 92703-1811
Phone (147) 332-1069

Other practice location 1

12666 Brookhurst St Ste 130
Garden Grove, CA 92840-4866
Phone (714) 332-1069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100605000106 CA Part B Supplier - Clinic/Group Practice 9133259906 Receives reassigned benefits from 6 practitioners
Practice locations: Garden Grove, CA; Santa Ana, CA

National Provider Directory

National Provider Directory

Locations

12666 Brookhurst St
Ste 130
Garden Grove, CA 92840
Phone (714) 332-1069

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1437485513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N FAIRVIEW ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927031811",
            "telephone_number": "147-332-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N FAIRVIEW ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927031811",
            "telephone_number": "714-332-1069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12666 Brookhurst St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928404866",
            "country_code": "US",
            "telephone_number": "714-332-1069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELVIN MAI, D.O., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "ORANTES",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "310-515-5004"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "20A8944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.