Healthcare Provider Details

I. General information

NPI: 1891621355
Provider Name (Legal Business Name): MALLARI OPTOMETRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 W WASHINGTON ST
SAN DIEGO CA
92103-1805
US

IV. Provider business mailing address

425 W BEECH ST UNIT 1053
SAN DIEGO CA
92101-8433
US

V. Phone/Fax

Practice location:
  • Phone: 858-610-7629
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JANEL MALLARI
Title or Position: OWNER/CEO
Credential: OD
Phone: 858-610-7629