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General NPI Number Information
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NPI Number | 1790640324
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Entity Type | Individual
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Provider Name | MALIA COLEMAN
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Gender | Female
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 14605 GRAHAM AVE
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City | VICTORVILLE
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State | CA
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Zip | 92394-7004
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Country | US
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Telephone | 760-843-9319
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Fax |
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Provider Business Mailing Address
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Address Line | 20988 QUILEUTE RD
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City | APPLE VALLEY
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State | CA
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Zip | 92308-6434
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Country | US
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Telephone | 909-830-3988
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State | CA
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