MEDICARE: RACHEL DEBORAH MALK RN

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	163W00000X	Registered Nurse	619848	CA
2	374J00000X	Doula		CA

General Provider Information

NPI Number	:	1639878291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL DEBORAH MALK RN

Provider Business Mailing Address
First Line	:	1475 S DURANGO AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-3329
Country	:	US
Telephone Number	:	323-251-2218
Fax Number	:

Provider Business Practice Location Address
First Line	:	1475 S DURANGO AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-3329
Country	:	US
Telephone Number	:	323-251-2218
Fax Number	:

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

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	05/08/2026

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