Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A24919 | CA |
Y | 208600000X | Surgeon | A24919 | CA |
NPI | 1003837543 |
---|---|
Provider Name | Riaz A Malik |
First Address | Redding, CA 96049-6084 |
Second Address | Redding, CA 96001-1153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 12/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A249190 | (05) | CA |
C03842 | (02) | CA |