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General NPI Number Information
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NPI Number | 1962677724
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Entity Type | Individual
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Provider Name | NAVIN A MALLAVARAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 7031 KOLL CENTER PKWY STE 100
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City | PLEASANTON
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State | CA
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Zip | 94566-3137
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Country | US
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Telephone | 925-469-9120
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Fax |
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Provider Business Mailing Address
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Address Line | 7031 KOLL CENTER PKWY STE 100
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City | PLEASANTON
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State | CA
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Zip | 94566-3137
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Country | US
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Telephone | 925-469-9120
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 245250
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 104871
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | A104871
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License Number State | CA
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