MS. CHEYANNE MALLAS


Address: 950 N Kings Rd, Suite 221, West Hollywood, CA 90069-4352
Phone: 9174783405

MS. CHEYANNE MALLAS (NPI# 1750570255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750570255
Entity Type Individual
Full Name MS. CHEYANNE MALLAS
Credential PHYSICIAN ASSISTANT
Practice Address 950 N Kings Rd
Suite 221
West Hollywood
CA 90069-4352
Practice Telephone 9174783405
Mailing Telephone 9174783405
Enumeration Date 2007-10-19
Last Update Date 2008-05-27
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
1076908 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 950 N KINGS RD
SUITE 221
City WEST HOLLYWOOD
State CA
Zip Code 90069-4352

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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

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Competitor

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City WEST HOLLYWOOD
Zip Code 90069

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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