Individual
NICOLAS MALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PET
Contact information
Practice address
734 10TH AVE, SAN DIEGO, CA 92101-6502
(619) 239-0024
Mailing address
1495 50TH ST, SAN DIEGO, CA 92102-2657
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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