Provider Demographics
NPI:1104447622
Name:ZOLTANI, MALALAI (MD)
Entity type:Individual
Prefix:MRS
First Name:MALALAI
Middle Name:
Last Name:ZOLTANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E SPRUCE AVE STE 431
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3330
Mailing Address - Country:US
Mailing Address - Phone:559-450-7449
Mailing Address - Fax:
Practice Address - Street 1:2006 SHAW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4192
Practice Address - Country:US
Practice Address - Phone:559-450-5880
Practice Address - Fax:559-450-5881
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA186627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine