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General NPI Number Information
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NPI Number | 1689816597
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Entity Type | Organization
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Legal Business Name | SABITA MALLA MD INC
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 23928 LYONS AVE STE 202
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2454
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Country | US
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Telephone | 661-799-7007
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Fax | 661-799-7215
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Provider Business Mailing Address
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Address Line | 23928 LYONS AVE STE 202
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2454
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Country | US
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Telephone | 661-799-7007
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Fax | 661-799-7215
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SABITA MALLA
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Credential | MD
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Telephone | 661-799-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A90206
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License Number State | CA
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