# SANTA MARIA MEDICAL CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992572234
- **Authorized official:** KAVEH KARANDISH MD (CEO/OWNER)
- **Authorized official phone:** (714) 953-6430

## Contact information

- **Practice address:** 1701 E MCFADDEN AVE STE D, SANTA ANA, CA 92705-4647
- **Practice address phone:** (714) 953-6430
- **Mailing address:** 1701 E MCFADDEN AVE STE D, SANTA ANA, CA 92705-4647
- **Mailing address phone:** (714) 953-6430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 12/06/2023
- **Last updated:** 08/26/2024