Malak, Taymour Edward
Malak, Taymour Edward is an sole proprietor health care provider with primary practice located at 2800 N California St Ste 11 2800 N. California Street Suite 11, Stockton CA 95204-3758. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Malak, Taymour Edward can be contacted via phone (209) 465-5891.Contact Information
Primary practice address
2800 N California St Ste 11 2800 N. California Street Suite 11
Stockton CA 95204-3758
Phone: (209) 465-5891
Fax: (209) 465-0008
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A400760 | California |
Allopathic & Osteopathic Physicians / General Practice | 208D00000X | A400760 | California |
Profile Details
NPI number | 1104931260 |
---|---|
LBN Legal business name | Malak, Taymour Edward |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 20th, 2006 |
Last updated | Feb 17th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1104931260 | NPPES |
California | MEDICAID | 00A4007607 | |
California | Other | A40076 | |
California | Other | 680045304 |
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