Provider Demographics
NPI:1619953502
Name:MALIK, NADIA S (MD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:S
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NADIA
Other - Middle Name:S
Other - Last Name:MALIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1351 ROYAL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3424
Mailing Address - Country:US
Mailing Address - Phone:925-485-9711
Mailing Address - Fax:925-485-9711
Practice Address - Street 1:975 SERENO DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2441
Practice Address - Country:US
Practice Address - Phone:707-651-2259
Practice Address - Fax:916-703-2274
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS12.20052471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN