Provider Demographics
NPI:1104111806
Name:MALEK, ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:MALEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 GOLD ST
Mailing Address - Street 2:5P
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2034
Mailing Address - Country:US
Mailing Address - Phone:818-606-8566
Mailing Address - Fax:
Practice Address - Street 1:10120 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3951
Practice Address - Country:US
Practice Address - Phone:702-487-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13796207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology