Individual provider Active NPI

Allan Edward Mallinger, M.D.

  • Psychiatry Physician
  • La Jolla, CA
National Provider Identifier
1316033269
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G24601 Issued in CA
Practice address
3252 Holiday CT Ste 205
La Jolla, CA 92037-1808
Phone
(619) 994-3053
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G24601 CA Primary

Addresses

Primary practice location

3252 Holiday CT Ste 205
La Jolla, CA 92037-1808

Mailing address

PO Box 22205
San Diego, CA 92192-2205
Phone (619) 994-3053

Other practice location 1

3551 Front St
San Diego, CA 92103
Phone (619) 692-9700

Other identifiers 1

IdentifierTypeStateIssuer
00G24601OtherCAMEDICAL

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
I20110606000195 CA Practitioner - Psychiatry 6800841990 Practice locations: La Jolla, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York Medical College, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3252 Holiday CT
Suite 205
La Jolla, CA 92037-1808
Phone (619) 994-3053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G24601CAMDPsychiatry Physician
24601CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Psychological Clinic Inc CurrentSince Oct 27, 2024 Accepting new patients
David S. Janowsky Psychiatry Past Accepting new patients

Locations

3252 Holiday Ct
Ste 205
La Jolla, CA 92037
Phone (619) 750-0970

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1316033269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921922205",
            "telephone_number": "619-994-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3252 HOLIDAY CT STE 205",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371808",
            "telephone_number": "619-994-3053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Front St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92103",
            "country_code": "US",
            "telephone_number": "619-692-9700",
            "fax_number": "619-291-0158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLINGER",
        "first_name": "ALLAN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G24601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "00G24601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.