Malcolm, Thomas Jonathan

Malcolm, Thomas Jonathan is an sole proprietor health care provider with primary practice located at 112 W Bennett Ave Suite 4, Glendora CA 91741-2568. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Malcolm, Thomas Jonathan can be contacted via phone (626) 335-2466.

Contact Information

Primary practice address
112 W Bennett Ave Suite 4 Glendora CA 91741-2568
Phone: (626) 335-2466
Fax: (626) 335-9686
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY4156 California

Profile Details

NPI number 1528083953
LBN Legal business name Malcolm, Thomas Jonathan
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2006
Last updated Jan 14th, 2009 - about 17 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 1528083953 NPPES
California MEDICAID 00PL41560

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