Individual
DR. GREGG S MALLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, ATC, CKTP
Contact information
Practice address
22661 LAMBERT ST, SUITE 207, LAKE FOREST, CA 92630-1612
(949) 916-9742
(949) 716-2694
Mailing address
22661 LAMBERT ST, SUITE 207, LAKE FOREST, CA 92630-1612
(949) 916-9742
(949) 716-2694
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2812
MA
111NX0800X
Orthopedic Chiropractor
Primary
30918
CA
Other
Enumeration date
03/13/2007
Last updated
03/01/2013
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