MEDICARE: MICHAEL Y MALIK MD

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	207P00000X	Emergency Medicine Physician	A69726	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295759132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL Y MALIK MD

Provider Business Mailing Address
First Line	:	3660 E IMPERIAL HWY
Second Line	:
City	:	LYNWOOD
State	:	CA
Zip	:	90262-2653
Country	:	US
Telephone Number	:	310-608-4898
Fax Number	:	310-608-4884

Provider Business Practice Location Address
First Line	:	3660 E IMPERIAL HWY
Second Line	:
City	:	LYNWOOD
State	:	CA
Zip	:	90262-2653
Country	:	US
Telephone Number	:	310-608-4898
Fax Number	:	310-608-4884

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	02/02/2011

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