Individual
DR. GAGAN DEEP MALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 NAPA VALLEJO HWY, NAPA, CA 94558-6234
(707) 253-5434
(707) 254-2423
Mailing address
596 EDENDERRY DR, VACAVILLE, CA 95688-8560
(707) 392-5086
(707) 392-5086
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
22370
OK
2084P0805X
Geriatric Psychiatry Physician
22370
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1122370
—
OK
05
—
200091340A
—
OK
Enumeration date
09/22/2006
Last updated
07/27/2014
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