Provider Demographics
NPI:1467568972
Name:MALIK, UZMA (CRNA)
Entity Type:Individual
Prefix:
First Name:UZMA
Middle Name:
Last Name:MALIK
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:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:3555 CESAR CHAVEZ
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4403
Practice Address - Country:US
Practice Address - Phone:415-647-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2012-05-16
Deactivation Date:2011-03-21
Deactivation Code:
Reactivation Date:2011-06-07
Provider Licenses
StateLicense IDTaxonomies
CA2581367500000X
CANA2581367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN4829310Medicaid
CAZZZ27338ZMedicare PIN
P76628Medicare UPIN
CAP01016827Medicare PIN
CABL090WMedicare PIN