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1114008554
JENNIFER REBECCA MALLOY
CAMPBELL, CA
NPI
1114008554
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: CA PA17849)
Enumeration Date
2006-10-18
Last Update Date
2010-02-26
Business Address
Mrs. JENNIFER REBECCA MALLOY PA-C
2255 S BASCOM AVE SUITE 200
CAMPBELL, CA 95008-7800
Phone number: 408-376-3626
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Mailing Address
Mrs. JENNIFER REBECCA MALLOY PA-C
2255 S BASCOM AVE SUITE 200
CAMPBELL, CA 95008-7800
Phone number: 408-376-3626
Copy
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