Provider Demographics
NPI:1871607283
Name:MALLINSON, DARREN
Entity type:Individual
Prefix:MR
First Name:DARREN
Middle Name:
Last Name:MALLINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 14TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2554
Mailing Address - Country:US
Mailing Address - Phone:858-755-1229
Mailing Address - Fax:858-755-0720
Practice Address - Street 1:317 14TH ST
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2554
Practice Address - Country:US
Practice Address - Phone:858-755-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT289942251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic