MEDICARE: VIDUR MALIK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	127957	CA

General Provider Information

NPI Number	:	1033647292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIDUR MALIK

Provider Business Mailing Address
First Line	:	225 CABRILLO HWY S STE 100A
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-1738
Country	:	US
Telephone Number	:	510-789-8037
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 CABRILLO HWY S STE 100A
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-1738
Country	:	US
Telephone Number	:	510-789-8037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	01/22/2026

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Directions to “ VIDUR MALIK ” Practice Location

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