Individual provider Active NPI

Lawrence Taymour Malak, MD

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1467773028
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A115345 Issued in CA
Practice address
3350 La Jolla Village Dr
Dept of Psychiatry - 116a
San Diego, CA 92161-0002
Phone
(858) 534-4040
NPI assigned
Jun 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 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 A115345 CA Primary

Addresses

Primary practice location

3350 La Jolla Village Dr
Dept of Psychiatry - 116a
San Diego, CA 92161-0002

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

4065 3rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2419

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
I20130820001075 CA Practitioner - Psychiatry 2860635950 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Baylor College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6753

4065 3Rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2545

6645 Alvarado Rd
San Diego, CA 92120-5208
Phone (858) 249-6748

6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-5273

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115345CAMDMarriage & Family Therapist
A115345CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Oct 14, 2014 Accepting new patients
County of San Diego CurrentSince Aug 18, 2013 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2013 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Oct 14, 2014 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 24, 2024 Accepting new patients
County of San Diego CurrentSince Aug 18, 2013 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 24, 2024 Accepting new patients
County of San Diego Current Accepting new patients
Regents of the University of California Psychiatry CurrentSince Jul 1, 2013 Accepting new patients

Locations

678 Third Ave
Chula Vista, CA 91910
Phone (619) 205-6349

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

8950 Villa La Jolla Dr
Ste C101
La Jolla, CA 92037
Phone (858) 249-1680

File 57326
Los Angeles, CA 90074

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

4065 3rd Ave
San Diego, CA 92103
Phone (619) 255-5120

3853 Rosecrans St
San Diego, CA 92110
Phone (619) 615-0439

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1467773028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "DEPT OF PSYCHIATRY - 116A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-534-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4065 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032184",
            "country_code": "US",
            "telephone_number": "619-515-2419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAK",
        "first_name": "LAWRENCE",
        "middle_name": "TAYMOUR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A115345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.