Provider Demographics
NPI:1447558549
Name:MALAKOFF, GREGORY STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:STEVEN
Last Name:MALAKOFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:450 S MAPLE DR APT 101
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4758
Mailing Address - Country:US
Mailing Address - Phone:310-663-9975
Mailing Address - Fax:310-274-3918
Practice Address - Street 1:450 S MAPLE DR APT 101
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4758
Practice Address - Country:US
Practice Address - Phone:310-663-9975
Practice Address - Fax:310-274-3918
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15472111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology