Provider Demographics
NPI:1124116462
Name:JAMES R MALINAK M.D. INC
Entity type:Organization
Organization Name:JAMES R MALINAK M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MALINAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-460-4050
Mailing Address - Street 1:5111 GARFIELD ST
Mailing Address - Street 2:STE A
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5103
Mailing Address - Country:US
Mailing Address - Phone:619-460-4050
Mailing Address - Fax:619-460-7441
Practice Address - Street 1:5111 GARFIELD ST
Practice Address - Street 2:STE A
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5103
Practice Address - Country:US
Practice Address - Phone:619-460-4050
Practice Address - Fax:619-460-7441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52238207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G522380Medicaid
CA00G522380Medicaid
A93141Medicare UPIN