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NPI 1518959162

NPI 1518959162 : CHARLES D. MALINICK M.D. : BREA, CA

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General NPI Number Information
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    NPI Number           |    1518959162
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    Entity Type          |    Individual 
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    Provider Name        |    CHARLES D. MALINICK M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/19/2005
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    3350 E BIRCH ST SUITE 100
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    City                 |    BREA
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    State                |    CA
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    Zip                  |    92821-6264
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    Country              |    US
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    Telephone            |    714-528-9592
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    Fax                  |    714-528-9606
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Provider Business Mailing Address
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    Address Line         |    3350 E BIRCH ST SUITE 100
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    City                 |    BREA
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    State                |    CA
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    Zip                  |    92821-6264
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    Country              |    US
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    Telephone            |    714-528-9592
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    Fax                  |    714-528-9606
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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       |    G59430
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    2084P0804X
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    Taxonomy Name        |    Child & Adolescent Psychiatry Physician
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    License Number       |    G59430
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    License Number State |    CA
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