Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | C50915 | |
N | 222Z00000X | Podiatrist | C50915 | |
Y | 224P00000X | Prosthetist | CP004017 |
NPI | 1144671405 |
---|---|
Provider Name | James Malinak |
First Address | Santa Clarita, CA 91321-2671 |
Second Address | Santa Clarita, CA 91321-2671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2016 |
Last Update Date | 28/06/2016 |