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General NPI Number Information
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NPI Number | 1053672600
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Entity Type | Organization
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Legal Business Name | MATTHEW MALAMET M.D. PC
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 12/14/2014
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Provider Practice Location Address
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Address Line | 16311 VENTURA BLVD SUITE 835
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City | ENCINO
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State | CA
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Zip | 91436-2124
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Country | US
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Telephone | 818-380-3130
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Fax | 818-221-0392
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Provider Business Mailing Address
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Address Line | 16311 VENTURA BLVD SUITE 835
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City | ENCINO
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State | CA
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Zip | 91436-2124
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Country | US
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Telephone | 818-380-3130
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Fax | 818-221-0392
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Authorized Official
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Title or Position | PLASTIC SURGEON / PRESIDENT
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Name | DR. MATTHEW DAVID MALAMET
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Credential | M.D.
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Telephone | 818-380-3130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A121376
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License Number State | CA
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