Individual
ANGELA MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3160 FOLSOM BLVD, SACRAMENTO, CA 95816-5219
(916) 733-5779
(916) 733-5940
Mailing address
3160 FOLSOM BLVD, SACRAMENTO, CA 95816-5219
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
PA16532
CA
207RG0100X
Gastroenterology Physician
Primary
PA16523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097156
HEALTH NET
CA
01
—
1750430
GREAT WEST
CA
01
—
2415601
CIGNA
CA
01
—
2689216
UNITED HEALTHCARE
CA
01
—
461137
INTERPLAN
CA
01
—
7765473
AETNA
CA
01
—
90131278
PACIFICARE
CA
05
—
PA16523
—
CA
Enumeration date
08/04/2006
Last updated
07/12/2007
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