Provider Demographics
NPI:1235273749
Name:USMAN, DAVE MALLARI (DNP, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:DAVE
Middle Name:MALLARI
Last Name:USMAN
Suffix:
Gender:M
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8672 BELMONT ST APT A
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-6026
Mailing Address - Country:US
Mailing Address - Phone:714-269-2022
Mailing Address - Fax:
Practice Address - Street 1:1621 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-4973
Practice Address - Country:US
Practice Address - Phone:310-631-3735
Practice Address - Fax:310-638-1326
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95008930363LC1500X
CA95008930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health