Mall, Dominique Lucienne
Mall, Dominique Lucienne is an individual health care provider with primary practice located at 11211 Sepulveda Blvd , Mission Hills CA 91345-1115. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Mall, Dominique Lucienne can be contacted via phone (818) 365-9531.Contact Information
Primary practice address
11211 Sepulveda Blvd
Mission Hills CA 91345-1115
Phone: (818) 365-9531
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | A86680 | California |
Profile Details
| NPI number | 1821043423 |
|---|---|
| LBN Legal business name | Mall, Dominique Lucienne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Jul 17th, 2012 - about 12 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 | 1821043423 | NPPES |
| California | MEDICAID | 0A8668000 |
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