Active NPI
Brenda J Malone, M.D.
- General Practice Physician
- Tracy, CA
National Provider Identifier
1013190263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- G48361
- Practice address
- 23233 Los Ranchos Dr
Tracy, CA 95304-9761 - Phone
- (209) 836-4417
- Fax
- (209) 836-4417
- NPI assigned
- Dec 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | G48361 | CA | Primary |
Addresses
Primary practice location
23233 Los Ranchos Dr
Tracy, CA 95304-9761
Mailing address
PO Box 324
Byron, CA 94514-0324
Phone (209) 836-4417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G48361 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369958400000",
"number": "1013190263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 324",
"city": "BYRON",
"state": "CA",
"postal_code": "945140324",
"telephone_number": "209-836-4417",
"fax_number": "209-836-4417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23233 LOS RANCHOS DR",
"city": "TRACY",
"state": "CA",
"postal_code": "953049761",
"telephone_number": "209-836-4417",
"fax_number": "209-836-4417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALONE",
"first_name": "BRENDA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-11",
"last_updated": "2013-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "G48361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.