MEDICARE: DR. GEETA K MALIK M.D.

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	207Q00000X	Family Medicine Physician	K5147	TX
2	207Q00000X	Family Medicine Physician	G79541	CA

General Provider Information

NPI Number	:	1740262302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEETA K MALIK M.D.

Provider Business Mailing Address
First Line	:	651 1ST ST W
Second Line	:	SUITE H
City	:	SONOMA
State	:	CA
Zip	:	95476-7045
Country	:	US
Telephone Number	:	707-938-3870
Fax Number	:	707-938-3895

Provider Business Practice Location Address
First Line	:	651 1ST ST W
Second Line	:	SUITE H
City	:	SONOMA
State	:	CA
Zip	:	95476-7045
Country	:	US
Telephone Number	:	707-938-3870
Fax Number	:	707-938-3895

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	02/25/2013

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