Individual provider Active NPI

Camillia Malhis

  • Student in an Organized Health Care Education/Training Program
  • Paterson, NJ
National Provider Identifier
1164090932
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(156) 265-2197
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

703 Main St
Paterson, NJ 07503-2621
Phone (156) 265-2197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251125001985 CA Practitioner - Anesthesiology 1456843648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital, Riverside Hospital, Riverside, CA, CCN 050686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
24230CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 8, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 8, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1164090932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "156-265-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "156-265-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHIS",
        "first_name": "CAMILLIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.