Provider Demographics
NPI:1063220986
Name:MALIK, MAJID WAZIR (PA)
Entity type:Individual
Prefix:
First Name:MAJID
Middle Name:WAZIR
Last Name:MALIK
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 KNOLLCREST DR STE 120
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0121
Mailing Address - Country:US
Mailing Address - Phone:530-392-4399
Mailing Address - Fax:530-903-4226
Practice Address - Street 1:415 KNOLLCREST DR STE 101
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0181
Practice Address - Country:US
Practice Address - Phone:530-392-4399
Practice Address - Fax:530-903-4226
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA66445363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant