Malm, Samantha

Malm, Samantha is an individual health care provider with primary practice located at 2500 Milvia St , Berkeley CA 94704. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Malm, Samantha can be contacted via phone (510) 204-5600.

Contact Information

Primary practice address
2500 Milvia St Berkeley CA 94704
Fax: (510) 204-5462
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A89453 California

Profile Details

NPI number 1396724266
LBN Legal business name Malm, Samantha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Nov 20th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396724266 NPPES
California Other A89453 STATE MEDICAL LICENSE

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