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General NPI Number Information
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NPI Number | 1235273749
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Entity Type | Individual
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Provider Name | DAVE MALLARI USMAN DNP, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1621 S ALAMEDA ST
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City | COMPTON
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State | CA
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Zip | 90220-4973
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Country | US
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Telephone | 310-631-3735
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Fax | 310-638-1326
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Provider Business Mailing Address
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Address Line | 8672 BELMONT ST APT A
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City | CYPRESS
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State | CA
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Zip | 90630-6026
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Country | US
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Telephone | 714-269-2022
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Fax |
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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 | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | NP95008930
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95008930
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License Number State | CA
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