Individual
HOSPICIO MALLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1346 SANDIA AVE, SUNNYVALE, CA 94089-2615
(408) 628-2874
Mailing address
1346 SANDIA AVE, SUNNYVALE, CA 94089-2615
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 36223
CA
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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