Individual provider Active NPI

Maria Mehaela Tiu, PA-C

  • Physician Assistant
  • Fullerton, CA
National Provider Identifier
1629322110
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22666 Issued in CA
Practice address
2720 N Harbor Blvd Ste 130
Fullerton, CA 92835-2625
Phone
(714) 449-6230
NPI assigned
Nov 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 22666 CA Primary

Addresses

Primary practice location

2720 N Harbor Blvd Ste 130
Fullerton, CA 92835-2625

Mailing address

972 La Paz Rd
Placentia, CA 92870-4229
Phone (714) 961-8498

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150211000163 CA Practitioner - Physician Assistant 5698090892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians

Practice addresses (Care Compare)

10165 Valley View St
Cypress, CA 90630-4602
Phone (714) 252-5016

14443 Culver Dr
14443 A
Irvine, CA 92604-0343
Phone (949) 767-8173

858 N Rose Dr
Suite C 2
Placentia, CA 92870-7522
Phone (714) 792-3736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Mar 21, 2023 Accepting new patients

Locations

2690 5th St
Ste B
Alameda, CA 94501
Phone (510) 439-9447

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

2010 E Carson St
Long Beach, CA 90807
Phone (213) 401-0371

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Organizations & group practices 2

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": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1629322110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 LA PAZ RD",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928704229",
            "telephone_number": "714-961-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD STE 130",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352625",
            "telephone_number": "714-449-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIU",
        "first_name": "MARIA",
        "middle_name": "MEHAELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.