Mary Grace Antoniette Mallari, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95033235 Issued in CA

Practice address

1300 N Mission Rd
Los Angeles, CA 90033-1021

Phone

(323) 409-1000

NPI assigned

Jan 7, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1548079130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22419 MARINE AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907454048",
            "telephone_number": "310-489-6436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N MISSION RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331021",
            "telephone_number": "323-409-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARI",
        "first_name": "MARY GRACE ANTONIETTE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95033235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abraham Malkin, M.D.
• Michelle Malkoukian
• Rebecca Mall
• Akshara Malla, MD, MPH
• Julie B Mallari, NP
• Neiel Mallari
• Cynthia S Mallatt-Grow, LMFT #85046
• Monica Mallek, AGACNP
• Jon Mallen-St. Clair, M.D.
• Aviva Maller, OTR

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.