Healthcare Provider Details

I. General information

NPI: 1376343582
Provider Name (Legal Business Name): MDSL HEALTH MI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 09/02/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W UNIVERSITY DR STE C-11
ROCHESTER MI
48307-1817
US

IV. Provider business mailing address

900 W UNIVERSITY DR STE C-11
ROCHESTER MI
48307-1817
US

V. Phone/Fax

Practice location:
  • Phone: 714-496-6650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MALINI RANAT
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 909-204-4191