MEDICARE: DR. NICOLA MALIK DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	59897	CA

General Provider Information

NPI Number	:	1497047922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLA MALIK DDS

Provider Business Mailing Address
First Line	:	7080 HOLLYWOOD BLVD STE 808
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6935
Country	:	US
Telephone Number	:	323-461-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	7080 HOLLYWOOD BLVD STE 808
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6935
Country	:	US
Telephone Number	:	323-461-9066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	05/03/2011

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