Provider Demographics
NPI:1891767729
Name:MALEK, EVA JOSEFINE (DC)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:JOSEFINE
Last Name:MALEK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 S DE ANZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3027
Mailing Address - Country:US
Mailing Address - Phone:408-973-1717
Mailing Address - Fax:408-973-1723
Practice Address - Street 1:10301 S DE ANZA BLVD
Practice Address - Street 2:STE 1
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3027
Practice Address - Country:US
Practice Address - Phone:408-973-1717
Practice Address - Fax:408-973-1723
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18868111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0188680Medicare ID - Type Unspecified