Healthcare Provider Details

I. General information

NPI: 1518959162
Provider Name (Legal Business Name): CHARLES D. MALINICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 E BIRCH ST SUITE 100
BREA CA
92821-6264
US

IV. Provider business mailing address

3350 E BIRCH ST SUITE 100
BREA CA
92821-6264
US

V. Phone/Fax

Practice location:
  • Phone: 714-528-9592
  • Fax: 714-528-9606
Mailing address:
  • Phone: 714-528-9592
  • Fax: 714-528-9606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG59430
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG59430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: