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Licensing details for: A 189733

Name: SAMPATH, MAYA ANUSUYA

License Type: Physician and Surgeon A

Primary Status: License Renewed & Current Primary Status Definition

School Name: University of Southern California Keck School of Medicine

Graduation Year: 2020

Previous Names: Sampath, Maya Anusuya

Address of Record

220 Palisade Dr
Ste 203
SANTA MARIA CA 93454
SANTA BARBARA county
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Issuance Date

August 30, 2023

Expiration Date

October 31, 2027

Current Date / Time

April 3, 2026
4:06:27 PM

Public Record Actions

Public Documents

License Relationships

Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Physician & Surgeon

Related Party Role: Postgraduate Training License

Name: SAMPATH, MAYA ANUSUYA

License/Registration Type: Postgraduate Training License

License Number: 4792 Primary Status: License Canceled

Address :
1400 E Church St
SANTA MARIA CA 93454-5906
SANTA BARBARA COUNTY

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Survey Information

The following information is self-reported by the licensee and has not been verified by the Board.

Current Training Status
Not in Training
Postgraduate Training Years
4
Primary Area of Practice
Obstetrics and Gynecology
Secondary Area of Practice
Not Applicable
ABMS Certifications
Other - None
Are you retired?
No
Practice Activities
Direct Patient Care (including telehealth) - 40+ Hours
Percentage (%) of patient care hours spent on telehealth - 0
Training - None
Research - None
Administration - 1-9 Hours
Other - None
Primary Practice Location
Zip - 93454-8903
United States Primary Practice Location
Secondary Practice Location
Zip - 93454
United States Secondary Practice Location
Are you Hispanic, Latino/a, or of Spanish origin?
Decline to State
Race
Decline to State
Language Fluency
Decline to State
Gender Identity
Decline to State

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