Provider Demographics
NPI:1639119977
Name:MALIK, LENA NERJIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LENA
Middle Name:NERJIS
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 E ROMIE LN
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4209
Mailing Address - Country:US
Mailing Address - Phone:831-422-9001
Mailing Address - Fax:
Practice Address - Street 1:610 E ROMIE LN
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4209
Practice Address - Country:US
Practice Address - Phone:831-422-9001
Practice Address - Fax:831-422-0577
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11828208000000X
CAA94846208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509315Medicaid