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DOMINIQUE LUCIENNE MALL MD. NPI 1821043423


NPI Information

NPI: 1821043423
Provider Name: DOMINIQUE LUCIENNE MALL, MD.
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

PECOS Registration: Yes

Address:
11211 SEPULVEDA BLVD
MISSION HILLS, CA
ZIP 91345
Phone: (818) 365-9531
Get Directions

Dominique Lucienne Mall, MD. is a nephrology internal medicine in Mission Hills, CA with 38 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Dominique Lucienne Mall, MD. NPI is 1821043423. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11211 SEPULVEDA BLVD
MISSION HILLS, CA
ZIP 91345-115
Phone: (818) 365-9531

The NPI 1821043423 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services (4 or more physician visits per month), patient 20 years of age and older (HCPCS:90960)
  • Dialysis services (2-3 physician visits per month), patient 20 years of age and older (HCPCS:90961)

The enumeration date for this NPI number is 5/23/2006 and was last updated on 7/17/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrologyA86680CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Z145955MEDICARE PINARIZONA
20A8668000MEDICAIDCALIFORNIA
3GE189ZMEDICARE PINCALIFORNIA
4Z145953MEDICARE PINARIZONA
5I12589MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.