Healthcare Provider Details

I. General information

NPI: 1023515988
Provider Name (Legal Business Name): MALLETTE ASMUTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BON AIR RD STE 100
LARKSPUR CA
94939-1144
US

IV. Provider business mailing address

12631 E 17TH AVE
AURORA CO
80045-2527
US

V. Phone/Fax

Practice location:
  • Phone: 415-927-0666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA209644
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR0070795
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: