Healthcare Provider Details

I. General information

NPI: 1356826051
Provider Name (Legal Business Name): AMBER MALANOWSKI ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 S PACIFIC COAST HWY
REDONDO BEACH CA
90277-6185
US

IV. Provider business mailing address

906 CALLE MIRAMAR
REDONDO BEACH CA
90277-6731
US

V. Phone/Fax

Practice location:
  • Phone: 320-444-3787
  • Fax:
Mailing address:
  • Phone: 320-444-3787
  • Fax: 888-707-8758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberND1015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: