Healthcare Provider Details
I. General information
NPI: 1295888055
Provider Name (Legal Business Name): MALIN PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
606 FOOTHILL RD
BEVERLY HILLS CA
90210-3404
US
IV. Provider business mailing address
606 FOOTHILL RD
BEVERLY HILLS CA
90210-3404
US
V. Phone/Fax
- Phone: 310-274-2349
- Fax: 310-274-6282
- Phone: 310-274-2349
- Fax: 310-274-6282
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LCS524 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MFC1818 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | G1611 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
ARTHUR
MALIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-274-2349