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Individual
MALLORY SHURTE TATE
Active
Individual
MALLORY SHURTE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A144255
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
03/26/2015
Last updated
12/14/2021
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