Healthcare Provider Details

I. General information

NPI: 1518263128
Provider Name (Legal Business Name): RENA D MALIK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax:
Mailing address:
  • Phone: 562-826-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberR9098
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number101278199
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberD85712
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number294488
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number036.131797
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberC186961
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberTPME5484
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number25MA11973900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: