Healthcare Provider Details

I. General information

NPI: 1366827479
Provider Name (Legal Business Name): SAPNA MALIK MBBS ,MD, MRCGP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAPNA MAHESH CHANDNA MBBS

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E ORANGEBURG AVE STE 330
MODESTO CA
95355-3396
US

IV. Provider business mailing address

737 W CHILDS AVE
MERCED CA
95341-6805
US

V. Phone/Fax

Practice location:
  • Phone: 209-726-7381
  • Fax:
Mailing address:
  • Phone: 866-682-4842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD20649
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA165241
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: