Provider Demographics
NPI:1699732727
Name:MALANI, NARENDRA (MD)
Entity type:Individual
Prefix:
First Name:NARENDRA
Middle Name:
Last Name:MALANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 NORRIS CANYON RD SUITE 308
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583
Mailing Address - Country:US
Mailing Address - Phone:925-866-8822
Mailing Address - Fax:925-866-8323
Practice Address - Street 1:5401 NORRIS CANYON RD SUITE 308
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-866-8822
Practice Address - Fax:925-866-8323
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43108174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A431080Medicaid
CA00A431080Medicaid
E13970Medicare UPIN