Individual
MR. MARIGANGAIAH MAHADEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 CHAPARRAL COURT, SUITE 102, ANAHEIM HILLS, CA 92808
(714) 998-1941
(714) 998-3472
Mailing address
125 CHAPARRAL COURT, SUITE 102, ANAHEIM HILLS, CA 92808
(714) 998-1941
(714) 998-3472
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A45109
CA
208000000X
Pediatrics Physician
A45109
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A451091
—
CA
Enumeration date
07/10/2006
Last updated
12/13/2011
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