Healthcare Provider Details

I. General information

NPI: 1194994764
Provider Name (Legal Business Name): ZEA NACHAMA MALAWA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 3RD ST
SAN FRANCISCO CA
94124-1443
US

IV. Provider business mailing address

3450 3RD ST
SAN FRANCISCO CA
94124-1443
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-1990
  • Fax:
Mailing address:
  • Phone: 415-600-1990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA100081
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: