Provider Demographics
NPI:1366867871
Name:MALETZ, ANASTASIA HOPE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANASTASIA
Middle Name:HOPE
Last Name:MALETZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ELROD RD BLDG 20
Mailing Address - Street 2:
Mailing Address - City:CAMP SMITH
Mailing Address - State:HI
Mailing Address - Zip Code:96861
Mailing Address - Country:US
Mailing Address - Phone:808-204-3642
Mailing Address - Fax:
Practice Address - Street 1:140 ELROD RD BLDG 20
Practice Address - Street 2:
Practice Address - City:CAMP SMITH
Practice Address - State:HI
Practice Address - Zip Code:96061
Practice Address - Country:US
Practice Address - Phone:808-204-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A15805207Q00000X, 2083P0901X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program