MEDICARE: DR. AKSHIV MALHOTRA 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	193200000X	Multi-Specialty Group	A142648	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RH0003X	Hematology & Oncology Physician	A142648	CA

General Provider Information

NPI Number	:	1629381819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKSHIV MALHOTRA MD

Provider Business Mailing Address
First Line	:	3100 SAN PABLO AVE STE 430
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-2498
Country	:	US
Telephone Number	:	415-476-3360
Fax Number	:	510-985-5202

Provider Business Practice Location Address
First Line	:	3100 SAN PABLO AVE STE 430
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-2498
Country	:	US
Telephone Number	:	415-476-3360
Fax Number	:	510-985-5202

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

Provider Enumeration Date	:	07/16/2010
Last Update Date	:	02/27/2020

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