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Individual

ALAN ELIE MALKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2415 BATH ST, SANTA BARBARA, CA 93105-4324
(805) 687-3744
(805) 687-6048
Mailing address
700 E REDLANDS BLVD, U515, REDLANDS, CA 92373-6109
(805) 687-3744
(805) 687-6048

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G43969
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G439690
CA
01
00G439692
MEDICARE INDIVIDUAL PTAN
CA
05
GR0079160
CA
05
GR0079161
CA
01
ZZZ13778Z
MEDICARE PIN
CA
01
ZZZ13779Z
MEDICARE PIN
Enumeration date
07/06/2006
Last updated
09/11/2016
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