Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | A149588 | CA |
Y | 2082S0105X | Plastic Hand Surgeon | A149588 | CA |
N | 2086S0105X | Surgery of the Hand | A149588 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | A149588 | CA |
NPI | 1972895027 |
---|---|
Provider Name | Dr. Menyoli Michael Malafa |
First Address | Los Angeles, CA 90033-2476 |
Second Address | Los Angeles, CA 90033-2476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2011 |
Last Update Date | 26/08/2021 |