Healthcare Provider Details

I. General information

NPI: 1427366194
Provider Name (Legal Business Name): SAEED MALEKAFZALI, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 W 6TH ST SUITE A
SAN PEDRO CA
90732-3514
US

IV. Provider business mailing address

1360 W 6TH ST SUITE A
SAN PEDRO CA
90732-3514
US

V. Phone/Fax

Practice location:
  • Phone: 310-514-0244
  • Fax: 310-514-1720
Mailing address:
  • Phone: 310-514-0244
  • Fax: 310-514-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA36075
License Number StateCA

VIII. Authorized Official

Name: SAEED MALEKAFZALI
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 310-514-0244