Healthcare Provider Details

I. General information

NPI: 1124108253
Provider Name (Legal Business Name): MALCOLM DAVID PAUL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 AVOCADO AVE 810
NEWPORT BEACH CA
92660-7720
US

IV. Provider business mailing address

1401 AVOCADO AVE 810
NEWPORT BEACH CA
92660-7720
US

V. Phone/Fax

Practice location:
  • Phone: 949-760-5047
  • Fax:
Mailing address:
  • Phone: 949-760-5047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG28409
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG28409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: