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General NPI Number Information
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NPI Number | 1023676376
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Entity Type | Individual
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Provider Name | JOSEPH MAHALLI
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Gender | Male
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Dates
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Enumeration Date | 06/02/2019
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1759 W AVENUE J STE 101
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City | LANCASTER
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State | CA
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Zip | 93534-2703
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Country | US
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Telephone | 661-948-1388
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Fax | 661-948-1223
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Provider Business Mailing Address
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Address Line | PO BOX 2768
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City | LANCASTER
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State | CA
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Zip | 93539-2768
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Country | US
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Telephone | 661-948-1388
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Fax | 661-948-1223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 20A19937
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License Number State | CA
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