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NPI Code Detail

MEDICARE: DR. JOSEPH G MALLON MD

MEDICARE: DR. JOSEPH G MALLON 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
1207R00000XInternal Medicine PhysicianA97574CA
2208M00000XHospitalist PhysicianA97574CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A97574OTHERCAMEDICAL LICENSE

General Provider Information

NPI Number : 1407041197
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH G MALLON MD
Provider Business Mailing Address
First Line : PO BOX 470054
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94147-0054
Country : US
Telephone Number : 888-962-7550
Fax Number : 818-408-4972
Provider Business Practice Location Address
First Line : 900 HYDE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-4806
Country : US
Telephone Number : 415-353-6817
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2007
Last Update Date : 12/08/2025

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