Provider Demographics
NPI:1912245127
Name:GARBUTT-ADAMS, MALKIA JANAE'
Entity Type:Individual
Prefix:MRS
First Name:MALKIA
Middle Name:JANAE'
Last Name:GARBUTT-ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 15TH ST UNIT 3792
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-7364
Mailing Address - Country:US
Mailing Address - Phone:323-521-6339
Mailing Address - Fax:
Practice Address - Street 1:425 15TH ST UNIT 3792
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-7364
Practice Address - Country:US
Practice Address - Phone:323-521-6339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health