Provider Demographics
NPI:1437588720
Name:COMSTOCK, MALIA (NP)
Entity Type:Individual
Prefix:
First Name:MALIA
Middle Name:
Last Name:COMSTOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVE
Mailing Address - Street 2:M631
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0106
Mailing Address - Country:US
Mailing Address - Phone:415-502-0530
Mailing Address - Fax:415-353-3729
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:M631
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0106
Practice Address - Country:US
Practice Address - Phone:415-502-0530
Practice Address - Fax:415-353-3729
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA16757363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics