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General NPI Number Information
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NPI Number | 1851169155
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Entity Type | Organization
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Legal Business Name | MALAMA MEDICAL GROUP CA PC
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 303 TWIN DOLPHIN DR FL 6
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City | REDWOOD CITY
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State | CA
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Zip | 94065-1497
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Country | US
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Telephone | 949-424-5479
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Fax |
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Provider Business Mailing Address
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Address Line | 303 TWIN DOLPHIN DR FL 6
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City | REDWOOD CITY
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State | CA
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Zip | 94065-1497
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Country | US
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Telephone | 949-424-5479
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | PRIYANKA K WALI
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Credential | MD
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Telephone | 949-424-5479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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