Individual
MS. CHEYANNE MALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
950 N KINGS RD, SUITE 221, WEST HOLLYWOOD, CA 90069-4352
(917) 478-3405
Mailing address
950 N KINGS RD, SUITE 221, WEST HOLLYWOOD, CA 90069-4352
(917) 478-3405
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1076908
CA
Other
Enumeration date
10/19/2007
Last updated
05/27/2008
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