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General NPI Number Information
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NPI Number | 1942147798
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Entity Type | Individual
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Provider Name | ROLAND JOHN C MALLARI PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 17220 NEWHOPE ST STE 120
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4283
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Country | US
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Telephone | 714-232-2125
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Fax |
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Provider Business Mailing Address
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Address Line | 6450 SAVOY CIR
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City | BUENA PARK
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State | CA
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Zip | 90621-2614
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Country | US
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Telephone | 714-232-2125
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 309924
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License Number State | CA
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