Malak, Taymour Edward

Malak, Taymour Edward is an sole proprietor health care provider with primary practice located at 2800 N California St Ste 11 2800 N. California Street Suite 11, Stockton CA 95204-3758. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Malak, Taymour Edward can be contacted via phone (209) 465-5891.

Contact Information

Primary practice address
2800 N California St Ste 11 2800 N. California Street Suite 11 Stockton CA 95204-3758
Phone: (209) 465-5891
Fax: (209) 465-0008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A400760 California
Allopathic & Osteopathic Physicians / General Practice 208D00000X A400760 California

Profile Details

NPI number 1104931260
LBN Legal business name Malak, Taymour Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2006
Last updated Feb 17th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104931260 NPPES
California MEDICAID 00A4007607
California Other A40076
California Other 680045304

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