Healthcare Provider Details

I. General information

NPI: 1366368672
Provider Name (Legal Business Name): MALHOTRA UROLOGY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 S SEPULVEDA BLVD STE 121
LOS ANGELES CA
90045-4849
US

IV. Provider business mailing address

9100 S SEPULVEDA BLVD STE 121
LOS ANGELES CA
90045-4849
US

V. Phone/Fax

Practice location:
  • Phone: 310-674-6785
  • Fax: 310-674-2161
Mailing address:
  • Phone: 310-674-6785
  • Fax: 310-674-2161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMEER MALHOTRA
Title or Position: PRESIDENT / CEO
Credential:
Phone: 310-903-9878