Provider Demographics
NPI:1184683302
Name:MALLORCA, FLORINDA GALANG (MD)
Entity Type:Individual
Prefix:
First Name:FLORINDA
Middle Name:GALANG
Last Name:MALLORCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20427 TINNIN RD
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-8524
Mailing Address - Country:US
Mailing Address - Phone:209-239-2743
Mailing Address - Fax:
Practice Address - Street 1:250 CHERRY LN
Practice Address - Street 2:SUITE 111
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-4395
Practice Address - Country:US
Practice Address - Phone:209-239-5867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50177208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF35335Medicare UPIN