JUSTIN ELI MALLIT (NPI# 1801141163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801141163 |
| Entity Type | Individual |
| Full Name | JUSTIN ELI MALLIT |
| Credential | PA-C |
| Practice Address |
855 E Madison Ave El Cajon CA 92020-3819 |
| Mailing Address |
425 N Date St Escondido CA 92025-3413 |
| Practice Telephone | 6194402751 |
| Mailing Telephone | 7607376960 |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2013-09-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA22408 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GROUP PTAN | W14158 | 01 |
| Street Address |
855 E MADISON AVE |
| City | EL CAJON |
| State | CA |
| Zip Code | 92020-3819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659301547 | Katherine Francis | Pediatrics | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2006-07-04 |
| 1437768017 | Alisia Alyas | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2020-07-29 |
| 1558826719 | Ellery Bouwkamp | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2019-02-01 |
| 1265966006 | Hannah Green | Family Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2017-04-19 |
| 1255726154 | Benison Lau | Internal Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2015-03-30 |
| 1477951523 | Lindsay Summers | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2014-12-05 |
| 1457769333 | Wegdan Hanna-haddad | Psychologist | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2014-07-24 |
| 1972929404 | Katherine Rose Lais | Registered Nurse | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2014-03-07 |
| 1043655004 | Arim Jayne Lee | Family Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2013-05-05 |
| 1083059265 | Judith Anne Tessema | Family Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2013-05-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447877840 | Margarito Alejandro Torres | Behavior Technician | 1005 S. Sunshine Ave, El Cajon, CA 92020 | 2020-07-01 |
| 1619503166 | Stella Zeicu Varagic | Dentist | 2526 Fletcher Pkwy, El Cajon, CA 92020 | 2020-03-17 |
| 1548827819 | Unexpected Possibilities, Inc | Non-emergency Medical Transport (VAN) | 1015 El Cajon Blvd # A, El Cajon, CA 92020 | 2019-05-22 |
| 1083175707 | Maricela Uriarte D.d.s | Dentist | 164 W Park Ave, El Cajon, CA 92020 | 2019-03-26 |
| 1881153963 | Rubeleta Medina | Nurse Practitioner | 1908 Friendship Drive, El Cajon, CA 92020 | 2019-03-18 |
| 1235619800 | Melissa Gomez | Counselor | 1600 Cuyamaca St, El Cajo, CA 92020 | 2018-08-14 |
| 1013407790 | Erin Metcalf | Family Medicine | 133 W Main St., 240, El Cajon, CA 92020 | 2018-05-17 |
| 1326535220 | Diana Orozco | Counselor | 1870cordell Court, Suite 101, El Cajon, CA 92020 | 2018-04-16 |
| 1104330646 | Mercy Air Service, Inc. | Ambulance | 545 Kenney St Ste G1a, El Cajon, CA 92020 | 2017-11-20 |
| 1790296184 | Way Cool Homecare, Inc | In Home Supportive Care | 900 N. Cuyamaca Street, Ste 201, El Cajon, CA 92020 | 2017-10-12 |
| Find all providers in zip 92020 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528345220 | Victoria Muchnik | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2011-11-08 |
| 1730200122 | Morgina Juliette Rao | Physician Assistant | 1111 W Chase Ave, El Cajon, CA 92020 | 2007-04-03 |
| 1518055615 | Kathryn A Lichtenstein | Physician Assistant | 300 S Pierce St, Suite 102, El Cajon, CA 92020-4124 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.