Healthcare Provider Details

I. General information

NPI: 1134912504
Provider Name (Legal Business Name): ATALIA MALIN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S KRAEMER BLVD STE 125
PLACENTIA CA
92870-6100
US

IV. Provider business mailing address

2150 S STATE COLLEGE BLVD APT 3053
ANAHEIM CA
92806-0134
US

V. Phone/Fax

Practice location:
  • Phone: 714-329-6080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: