MEDICARE: YONATAN MAHLLER MD PHD INC

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	207V00000X	Obstetrics & Gynecology Physician	A117135	CA

General Provider Information

NPI Number	:	1063833184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YONATAN MAHLLER MD PHD INC

Provider Business Mailing Address
First Line	:	320 SUPERIOR AVE STE 290
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-6140
Country	:	US
Telephone Number	:	949-375-8244
Fax Number	:	949-398-9812

Provider Business Practice Location Address
First Line	:	320 SUPERIOR AVE STE 290
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-6140
Country	:	US
Telephone Number	:	949-375-8244
Fax Number	:	949-398-9812

Authorized Official
Title or Position	:	CEO
Name	:	DR. YONATAN MAHLLER
Credential	:	MD PHD
Telephone Number	:	513-304-1011

Provider Enumeration Date	:	12/16/2013
Last Update Date	:	09/11/2025

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