Provider Demographics
NPI:1760488415
Name:MALAMET, RAYMOND L (MD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:L
Last Name:MALAMET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SANTA RITA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1466
Mailing Address - Country:US
Mailing Address - Phone:650-201-0363
Mailing Address - Fax:
Practice Address - Street 1:70 SANTA RITA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1466
Practice Address - Country:US
Practice Address - Phone:650-201-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0027937207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD356091100Medicaid
MDKN96KR97Medicare ID - Type Unspecified
MD356091100Medicaid