DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. MOHAN MALLAM, M.D.

Active Sole Proprietor

DR. MOHAN MALLAM, M.D. is a Gastroenterology healthcare provider located in BARSTOW, California. NPI 1538161443 is currently active in the NPPES registry. Verify at CMS.

Gastroenterology · BARSTOW, CA

Registration Details

NPI Number
1538161443
Provider Type
Individual
Gender
Male
NPI Issued
Aug 10, 2005 (21.045544697703 yrs)
Last Updated
Mar 11, 2008
Licenses
A42919 (CA)
A42919 (CA)
Sole Proprietor
Yes

Practice Information

Address
303 E BUENA VISTA ST
BARSTOW, CA, 923112803
Browse CA providers · Browse ZIP 92311
Phone
7602564601
Fax
7602560310
Primary Specialty
Gastroenterology
207RG0300X
Additional Specialty
Gastroenterology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.