Malibu Outpatient Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MALIBU OUTPATIENT INC

Practice address

28955 Pacific Coast Hwy
Ste 210
Malibu, CA 90265-3953

Phone

(310) 579-6063

NPI assigned

Sep 26, 2016

Organization subpart

No

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

Authorized official

Name

Evan Haines

Title

Ceo

Phone

(310) 579-6063

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1225587629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30765 PACIFIC COAST HWY",
            "address_2": "STE 135",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902653646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28955 PACIFIC COAST HWY",
            "address_2": "STE 210",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902653953",
            "telephone_number": "310-579-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIBU OUTPATIENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "HAINES",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-579-6063"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Malibu Medical Corporation
• Malibu Occupational & Speech Therapy
• Malibu Renewal Centre
• Malibu Seaside Serenity Cove, Inc.
• Malibu TMS
• Litos O. Mallare, M.D.
• Maribel Mancillas

• Community/Behavioral Health Agency in Malibu, CA
• Providers in Malibu, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.