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General NPI Number Information
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NPI Number | 1205592458
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Entity Type | Organization
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Legal Business Name | FMALIKMD
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 23181 LA CADENA DR
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1479
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Country | US
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Telephone | 480-603-5352
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Fax |
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Provider Business Mailing Address
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Address Line | 63 BOLIDE
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City | IRVINE
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State | CA
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Zip | 92618-1314
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Country | US
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Telephone | 480-603-5352
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. FATIMA MALIK
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Credential | MD
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Telephone | 480-603-5352
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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 |
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License Number State |
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