Healthcare Provider Details

I. General information

NPI: 1326350505
Provider Name (Legal Business Name): VANI MALLADI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 E WILLIAMS FIELD RD
GILBERT AZ
85295-5202
US

IV. Provider business mailing address

87 E WILLIAMS FIELD RD
GILBERT AZ
85295-5202
US

V. Phone/Fax

Practice location:
  • Phone: 480-726-3813
  • Fax: 480-782-8695
Mailing address:
  • Phone: 480-726-3813
  • Fax: 480-782-8695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS017458
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: