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General NPI Number Information
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NPI Number | 1265095681
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Entity Type | Individual
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Provider Name | SAMUEL JOSEPH MALIAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 576 HARTNELL ST
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City | MONTEREY
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State | CA
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Zip | 93940-2833
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Country | US
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Telephone | 831-624-5311
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 DEERVIEW CRESCENT
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City | LASALLE
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State | ONTARIO
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Zip | N9J0A2
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Country | CA
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301506194
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A190664
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License Number State | CA
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