MEDICARE: MS. ANGELA MALLARI VEGA NP

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	363LA2100X	Acute Care Nurse Practitioner	21740	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538400361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA MALLARI VEGA NP

Provider Business Mailing Address
First Line	:	1275 CRANE ST
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-4212
Country	:	US
Telephone Number	:	650-206-8342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1275 CRANE ST
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-4212
Country	:	US
Telephone Number	:	650-206-8342
Fax Number	:

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

Provider Enumeration Date	:	03/04/2013
Last Update Date	:	09/04/2024

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