Mallery, John A

Mallery, John A is an sole proprietor health care provider with primary practice located at 150 Catherine Lane #D, Grass Valley CA 95945. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Mallery, John A can be contacted via phone (530) 477-8358.

Contact Information

Primary practice address
150 Catherine Lane #D Grass Valley CA 95945
Phone: (530) 477-8358
Fax: (530) 477-2015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 00G51106 California

Profile Details

NPI number 1780664201
LBN Legal business name Mallery, John A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2006
Last updated Apr 22nd, 2010 - about 16 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 1780664201 NPPES
California MEDICAID GR0045980
California Other 00G511061

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