Healthcare Provider Details

I. General information

NPI: 1174818587
Provider Name (Legal Business Name): ADHAM NABIL MALATY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 CLIFF DR STE 1
SANTA BARBARA CA
93109-1502
US

IV. Provider business mailing address

319 SALIDA DEL SOL
SANTA BARBARA CA
93109-2021
US

V. Phone/Fax

Practice location:
  • Phone: 713-940-7674
  • Fax:
Mailing address:
  • Phone: 713-940-7674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35-122246
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA145692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: