Individual
JOEL MALLARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP, CNS
Contact information
Practice address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-2226
Mailing address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95010692
CA
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
Primary
3513
CA
Other
Enumeration date
07/31/2018
Last updated
06/11/2019
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