Provider Demographics
NPI:1003185992
Name:MALYUGA, NATALYA (NP)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:MALYUGA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:NATALYA
Other - Middle Name:
Other - Last Name:ALGULIEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1101 CAPP ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4697
Mailing Address - Country:US
Mailing Address - Phone:415-841-1427
Mailing Address - Fax:
Practice Address - Street 1:1101 CAPP ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4697
Practice Address - Country:US
Practice Address - Phone:415-841-1427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA639386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily