Mallya, Sanjay M
Mallya, Sanjay M is an individual health care provider with primary practice located at 10833 Le Conte Ave Chs 10-165, Los Angeles CA 90095-1668. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Radiology, which is considered as his primary health care specialty. Mallya, Sanjay M can be contacted via phone (310) 825-5634.Contact Information
Primary practice address
10833 Le Conte Ave Chs 10-165
Los Angeles CA 90095-1668
Phone: (310) 825-5634
Fax: (310) 206-2748
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Radiology | 1223X0008X | 9026 | Connecticut |
| Dental Providers / Oral and Maxillofacial Radiology | 1223X0008X | SP-251 | California |
Profile Details
| NPI number | 1538158043 |
|---|---|
| LBN Legal business name | Mallya, Sanjay M |
| Credentials | B.D.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2005 |
| Last updated | Mar 2nd, 2010 - about 14 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 | 1538158043 | NPPES |
| Connecticut | MEDICAID | 004010807 |
Popular Providers
-
Pettigrew, James C
1600 Sw Archer Rd , Gainesville FL 32610-3003 -
Reeves, Teresa Ellen
60 Mdg/Sgdd 101 Bodin Circle, Travis Afb, Travis Afb CA 94535 -
Buckley, Steven Boyd
4499 Medical Dr Suite 190, San Antonio TX 78229-3735 -
Phillips, Billy James
H 2005 Knight Lane Navy Medicine Support Command, Attn: Medical Staff Serv, Jacksonville FL 32212-0140 -
White, Stuart C.
10833 Le Conte Ave. Chs 10-165 , Los Angeles CA 90095-1668 -
Franco, James Edward
4499 Medical Dr Suite 190, San Antonio TX 78229-3735 -
Parrone, Martina T
155 5Th St , San Francisco CA 94103-2919 -
Tyndall, Donald A
Unc Dental Faculty Practice 117 Brauer Hall, Cb #7450, Chapel Hill NC 27599-7450