Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E1516 | CA |
N | 222Z00000X | Podiatrist | E1516 | CA |
N | 213EP1101X | Primary Podiatric Medicine | E1516 | CA |
N | 213ES0131X | Foot Surgery | E1516 | CA |
NPI | 1194833608 |
---|---|
Provider Name | Dr. John Joseph Malone |
First Address | San Diego, CA 92161-0001 |
Second Address | San Diego, CA 92161-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 08/07/2007 |