Provider Demographics
NPI:1578744454
Name:MALA ASHOK MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MALA ASHOK MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MALA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-423-5800
Mailing Address - Street 1:4001 J ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3626
Mailing Address - Country:US
Mailing Address - Phone:916-423-5800
Mailing Address - Fax:916-427-1292
Practice Address - Street 1:112 FOUNTAIN OAKS CIR
Practice Address - Street 2:250
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3967
Practice Address - Country:US
Practice Address - Phone:916-427-1292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85579207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty