Healthcare Provider Details
I. General information
NPI: 1215497854
Provider Name (Legal Business Name): ADIL AMIR MALIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/20/2019
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1575 7TH AVE
SAN FRANCISCO CA
94122-3704
US
IV. Provider business mailing address
PO BOX 591044
SAN FRANCISCO CA
94159-1044
US
V. Phone/Fax
- Phone: 415-566-1200
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081S0010X |
| Taxonomy | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | A201925 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | A201925 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: