Individual
ALEXANDER OTE MALLARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 J ST, SACRAMENTO, CA 95819-3626
(916) 453-4966
(916) 966-3189
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
269830
NY
208M00000X
Hospitalist Physician
Primary
269830
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01131126/RGH
—
NY
05
—
03007063/NWK
—
NY
05
—
03393148
—
NY
Enumeration date
09/17/2008
Last updated
12/22/2021
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