Provider Demographics
NPI:1891777108
Name:MALEE, TERRANCE J (MD)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:J
Last Name:MALEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 994032
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-4032
Mailing Address - Country:US
Mailing Address - Phone:530-241-0473
Mailing Address - Fax:530-241-5377
Practice Address - Street 1:3270 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2504
Practice Address - Country:US
Practice Address - Phone:530-222-6886
Practice Address - Fax:530-222-4480
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG16857207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39932Medicare UPIN
CA00G168570Medicare ID - Type Unspecified