Organization
GMC HEALTHCARE PLLC
Active
Organization
GMC HEALTHCARE PLLC
Active
Other names
GMC Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY V. MALLARI PMHNP-BC, FNP-BC (ADMINISTRATOR/ PROVIDER)
(602) 908-8580
Entity
Organization
Contact information
Practice address
10250 N 124TH ST, SCOTTSDALE, AZ 85259-5201
(602) 603-4660
(602) 860-6050
Mailing address
10250 N 124TH ST, SCOTTSDALE, AZ 85259-5201
(602) 603-4660
(602) 860-6050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D2299517
CLIA
—
05
—
205177
—
AZ
Enumeration date
10/19/2023
Last updated
04/03/2025
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