Provider Demographics
NPI:1861489155
Name:HELENE B. MALABED D.O. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HELENE B. MALABED D.O. A PROFESSIONAL CORPORATION
Other - Org Name:FAMILY PRACTICE & OSTEOPATHIC THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:MALABED
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-436-1929
Mailing Address - Street 1:2443 FAIR OAKS BLVD
Mailing Address - Street 2:#520
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7684
Mailing Address - Country:US
Mailing Address - Phone:916-436-1929
Mailing Address - Fax:877-496-6150
Practice Address - Street 1:3701 J ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5542
Practice Address - Country:US
Practice Address - Phone:916-436-1929
Practice Address - Fax:877-496-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABM3693442OtherDEA #
CA=========OtherTAX ID #
CABM3693442OtherDEA #
CA020A67781Medicare ID - Type UnspecifiedMEDICARE