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General NPI Number Information
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NPI Number | 1336869049
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Entity Type | Individual
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Provider Name | GIANCARLO MALERBA DDS
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Gender | Male
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1447 COLORADO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041-2338
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Country | US
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Telephone | 323-255-1708
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Fax |
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Provider Business Mailing Address
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Address Line | 11058 CHANDLER BLVD APT 5071
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-5037
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Country | US
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Telephone | 404-520-6954
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN122855
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License Number State | GA
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