Provider Demographics
NPI:1447035480
Name:MAYA PHARMACEUTICAL GROUP INC
Entity type:Organization
Organization Name:MAYA PHARMACEUTICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALZALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-567-6402
Mailing Address - Street 1:31961 DOVE CANYON DR STE D
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-3722
Mailing Address - Country:US
Mailing Address - Phone:949-567-6402
Mailing Address - Fax:
Practice Address - Street 1:31961 DOVE CANYON DR STE D
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-3722
Practice Address - Country:US
Practice Address - Phone:949-567-6402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy