Individual
KERRY D MALIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1780 N STATE ROUTE 89, CHINO VALLEY, AZ 86323-5695
(928) 460-5214
Mailing address
1780 N STATE ROUTE 89, CHINO VALLEY, AZ 86323-5695
(928) 460-5214
(928) 441-2915
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5167
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548241128
—
NV
01
—
P00942209
RAILROAD MEDICARE
NV
Enumeration date
11/09/2005
Last updated
07/02/2026
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