Provider Demographics
NPI:1013198720
Name:SERING, MALIA ANN (PA)
Entity Type:Individual
Prefix:MRS
First Name:MALIA
Middle Name:ANN
Last Name:SERING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:MALIA
Other - Middle Name:ANN
Other - Last Name:TILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3629 VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4522
Mailing Address - Country:US
Mailing Address - Phone:760-757-7546
Mailing Address - Fax:760-828-9140
Practice Address - Street 1:3629 VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4522
Practice Address - Country:US
Practice Address - Phone:760-757-7546
Practice Address - Fax:760-828-9140
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 19459363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA19459Medicaid
CAWPA19459DOtherMEDICARE
CAWPA19459BOtherMEDICARE
CA1013198720OtherNPI NUMBER
CAWPA19459COtherMEDICARE
CAWPA19459AOtherMEDICARE
CAWPA19459BOtherMEDICARE