Provider Demographics
NPI:1679171896
Name:MAAG, LAUREN ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANNE
Last Name:MAAG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16602 GRAHAM PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-3619
Mailing Address - Country:US
Mailing Address - Phone:209-470-6607
Mailing Address - Fax:
Practice Address - Street 1:9900 TALBERT AVE STE 103A
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5153
Practice Address - Country:US
Practice Address - Phone:657-259-0050
Practice Address - Fax:657-244-8019
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2024-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA58654363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant