Individual
DR. MALLORY E NOVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
400 N PEPPER AVE # 206, COLTON, CA 92324-1801
(909) 580-2270
(909) 580-3289
Mailing address
10273 NORTHRIDGE DR, RANCHO CUCAMONGA, CA 91737-3042
(406) 498-1090
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20A13191
CA
207V00000X
Obstetrics & Gynecology Physician
49924
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427324185
NPI
MT
05
—
1427324185
—
MT
Enumeration date
03/27/2012
Last updated
02/19/2024
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