MEDICARE: ROMMY MALAEB

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1710840418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROMMY MALAEB

Provider Business Mailing Address
First Line	:	939 DANA CIR
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94550-3781
Country	:	US
Telephone Number	:	925-487-2386
Fax Number	:

Provider Business Practice Location Address
First Line	:	1162 MONTGOMERY DR FL 2
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95405-4802
Country	:	US
Telephone Number	:	707-890-4100
Fax Number	:

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ ROMMY MALAEB ” Practice Location

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