Provider Demographics
NPI:1447217815
Name:MALINA, DEBRA PECKA (CRNA)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:PECKA
Last Name:MALINA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41710 MONTEREY PL
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-7935
Mailing Address - Country:US
Mailing Address - Phone:901-289-7446
Mailing Address - Fax:
Practice Address - Street 1:41710 MONTEREY PL
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-7935
Practice Address - Country:US
Practice Address - Phone:901-289-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9223769367500000X
TN10484367500000X
CA95000248367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3626339Medicare PIN