Dominique Mall,md,inc
NPI #1053465062 in Marina Del Rey, California
Provider Information
- NPI Number
- 1053465062
- Entity Type
- Organization
- Organization Name
- Dominique Mall,md,inc
- Primary Specialty
- Internal Medicine - Nephrology
- Enumeration Date
- Jan 23, 2007
- Last Updated
- Aug 24, 2011
Practice Location
- Address
- 13911 OLD HARBOR LN
- Address 2
- #306
- City
- Marina Del Rey
- State
- California
- ZIP Code
- 90292-7395
- Phone
- (310) 577-9547
Authorized Official
- Name
- DR. DOMINIQUE LUCIENNE MALL, MD
- Title
- PRESIDENT
- Phone
- (310) 902-8947
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Nephrology — Nephrology |
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