Healthcare Provider Details

I. General information

NPI: 1811070394
Provider Name (Legal Business Name): NASEEM MALIK RN, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W. CARSON ST. HARBOR UCLA MEDICAL CENTER
TORRANCE CA
90509-2004
US

IV. Provider business mailing address

P.O. BOX 4575 COVINA
COVINA CA
91723-4575
US

V. Phone/Fax

Practice location:
  • Phone: 310-618-9687
  • Fax:
Mailing address:
  • Phone: 714-865-8160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number432471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: