Basic Information
| Provider Information | |||||||||
| NPI: | 1952608952 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALSI | ||||||||
| FirstName: | MARIA JAZMIN | ||||||||
| MiddleName: | LUMBA | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7629 HOLDER ST | ||||||||
| Address2: | |||||||||
| City: | BUENA PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906201613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146844919 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10182 INDIANA AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925035304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9515092400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2011 | ||||||||
| LastUpdateDate: | 02/28/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 506402 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.