Provider Demographics
NPI:1740262302
Name:MALIK, GEETA K (MD)
Entity type:Individual
Prefix:DR
First Name:GEETA
Middle Name:K
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:651 1ST ST W
Mailing Address - Street 2:SUITE H
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-7045
Mailing Address - Country:US
Mailing Address - Phone:707-938-3870
Mailing Address - Fax:707-938-3895
Practice Address - Street 1:651 1ST ST W
Practice Address - Street 2:SUITE H
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-7045
Practice Address - Country:US
Practice Address - Phone:707-938-3870
Practice Address - Fax:707-938-3895
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2013-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5147207Q00000X
CAG79541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00952Medicare UPIN
TX82972JMedicare ID - Type Unspecified