Individual provider Active NPI

Shalu Kaur Malli, MD

  • Family Medicine Physician
  • Clovis, CA
National Provider Identifier
1366175853
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A204881 Issued in CA
Practice address
585 N Halifax Ave Ste 101
Clovis, CA 93611-7276
Phone
(559) 603-7420
NPI assigned
Jul 2, 2022
Last updated
Jan 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A204881 CA Primary

Addresses

Primary practice location

585 N Halifax Ave Ste 101
Clovis, CA 93611-7276

Mailing address

PO Box 889442
Los Angeles, CA 90088-9442

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
I20251010003515 CA Practitioner - Family Practice 8729585096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

45 E River Park PL W
Fresno, CA 93720-1565
Phone (559) 320-0530

585 N Halifax Ave
Suite 102
Clovis, CA 93611-7276
Phone (559) 603-7400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A204881CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Sep 15, 2025 Accepting new patients
Fresno Community Hospital and Medical Center PastSince Sep 28, 2025 Accepting new patients

Locations

585 N Halifax Ave
Clovis, CA 93611
Phone (559) 603-7415

585 N Halifax Ave
Ste 101
Clovis, CA 93611
Phone (559) 603-7420

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1656720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1366175853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 889442",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900889442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 N HALIFAX AVE STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936117276",
            "telephone_number": "559-603-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLI",
        "first_name": "SHALU",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-02",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A204881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.