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Individual

MALCOLM B DICK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-8068
(714) 456-3765
Mailing address
PO BOX 54778, LOS ANGELES, CA 90054-0778
(714) 456-8068
(714) 456-3765

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
PSY14133
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY141330
MEDI-CAL PROVIDER #
CA
Enumeration date
05/18/2006
Last updated
07/09/2007
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