Healthcare Provider Details

I. General information

NPI: 1003073776
Provider Name (Legal Business Name): STERLING LEAF MALISH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 TOLL GATE RD
WARWICK RI
02886-2759
US

IV. Provider business mailing address

1245 WILSHIRE BLVD SUITE 407
LOS ANGELES CA
90017-4804
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-7000
  • Fax:
Mailing address:
  • Phone: 213-977-4979
  • Fax: 213-977-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA94784
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA94784
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA94784
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMD15154
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: