DOMINIQUE MALL,MD,INC
NPI 1053465062
Internal Medicine - Nephrology in Marina Del Rey, CA

Q: What is Dominique Mall,md,inc's NPI number?

The NPI number for Dominique Mall,md,inc is 1053465062. It was assigned to this organization in the NPPES registry on January 23, 2007.

Q: What is Dominique Mall,md,inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Active since January 23, 2007

13911 OLD HARBOR LN, #306, MARINA DEL REY, CA 90292(310) 577-9547(310) 577-9547 Get Directions Write a Review

NPPES record last updated: August 24, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dominique Mall,md,inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINIQUE MALL,MD,INC (NPI 1053465062) is a healthcare organization registered as a nephrology in Marina Del Rey, California and active in the NPI registry since January 2007. The organization lists Dominique Lucienne Mall, President, as its authorized official.

NPPES Registry Identity

NPI1053465062

Entity TypeOrganization

Primary Taxonomy207RN0300X

Legal Business NameDOMINIQUE MALL,MD,INC

Location Address13911 OLD HARBOR LN, #306Marina Del Rey, CA 90292-7395

Mailing Address13911 Old Harbor Ln, #306Marina Del Rey, CA 90292-7395 · (310) 577-9547 · Fax (310) 577-9547

Phone(310) 577-9547

Fax(310) 577-9547

Organization SubpartNo

Authorized OfficialDominique Lucienne MallPresident · (310) 902-8947

Enumeration DateJanuary 23, 2007

Last NPPES UpdateAugust 24, 2011

✔ NPI 1053465062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

13911 OLD HARBOR LN, Marina Del Rey, CA 90292

Open in Google Maps ↗

Other Identifiers 2

Medicare PINZ145955AZ

Medicare PINZ145953AZ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominique Mall,md,inc's NPI number?

The NPI number for Dominique Mall,md,inc is 1053465062. It was assigned to this organization in the NPPES registry on January 23, 2007.

Where is Dominique Mall,md,inc located?

Dominique Mall,md,inc is located at 13911 Old Harbor Ln #306, Marina Del Rey, CA 90292. The listed phone number is (310) 577-9547.

What is Dominique Mall,md,inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

When was this NPI record last updated?

The NPPES record for Dominique Mall,md,inc was last updated on August 24, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.