Healthcare Provider Details

I. General information

NPI: 1265369425
Provider Name (Legal Business Name): THRIVE MALIBU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 WESTLAKE BLVD
MALIBU CA
90265-2443
US

IV. Provider business mailing address

265 WESTLAKE BLVD
MALIBU CA
90265-2443
US

V. Phone/Fax

Practice location:
  • Phone: 415-430-7465
  • Fax:
Mailing address:
  • Phone: 415-430-7465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID SHALEM
Title or Position: CEO
Credential:
Phone: 415-430-7465