Active NPI
Malama Medical Group
- Obesity and Weight Management Nutrition Registered Dietitian
- Boulder, CO
National Provider Identifier
1912774167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity and Weight Management Nutrition Registered Dietitian
- Legal business name
- MALAMA MEDICAL GROUP
- Practice address
- 1942 Broadway St.
Ste. 314C
Boulder, CO 80302 - Phone
- (949) 424-5479
- NPI assigned
- Dec 7, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Priyanka Wali, MD
- Title
- Owner
- Phone
- (408) 256-3180
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | |||
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | Primary | ||
| Maternal Newborn Registered Nurse | 163WM0102X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Community Health Worker | 172V00000X | |||
| Case Management Agency | 251B00000X | |||
| Doula | 374J00000X |
Addresses
Primary practice location
1942 Broadway St.
Ste. 314C
Boulder, CO 80302
Mailing address
2261 Market St # 4785
San Francisco, CA 94114-1612
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701907200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780531200000",
"number": "1912774167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2261 MARKET ST # 4785",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941141612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1942 BROADWAY ST.",
"address_2": "STE. 314C",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "949-424-5479"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MALAMA MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2023-12-07",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A",
"authorized_official_last_name": "WALI",
"authorized_official_first_name": "PRIYANKA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "408-256-3180",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1201X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": null,
"license": null,
"primary": true
},
{
"code": "163WM0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Maternal Newborn",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Doula",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.