Provider Demographics
NPI:1346774882
Name:MALIK MD CLINIC, LLC
Entity type:Organization
Organization Name:MALIK MD CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ATIF
Authorized Official - Middle Name:M
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-699-2054
Mailing Address - Street 1:2410 W RAY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3549
Mailing Address - Country:US
Mailing Address - Phone:480-699-2054
Mailing Address - Fax:480-699-1257
Practice Address - Street 1:2410 W RAY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3549
Practice Address - Country:US
Practice Address - Phone:480-699-2054
Practice Address - Fax:480-699-1257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty