Individual
MAGIE M. MALARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
703 PIER AVE, SUITE B138, HERMOSA BEACH, CA 90254-3949
(310) 376-8116
(310) 376-8166
Mailing address
703 PIER AVE, SUITE B138, HERMOSA BEACH, CA 90254-3949
(310) 376-8116
(310) 376-8166
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G85145
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G851450
BLUE SHIELD
CA
05
—
00G851450
—
CA
Enumeration date
07/05/2006
Last updated
04/06/2012
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