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General NPI Number Information
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NPI Number | 1689788283
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Entity Type | Individual
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Provider Name | FAWAD MALIK MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 1838 EL CAMINO REAL SUITE 208
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City | BURLINGAME
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State | CA
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Zip | 94010-3126
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Country | US
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Telephone | 415-775-7766
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Fax | 650-259-7556
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Provider Business Mailing Address
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Address Line | 4104 24TH ST # 521
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3615
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Country | US
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Telephone | 415-775-7766
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Fax | 650-259-7556
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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 | A81928
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License Number State | CA
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