Basic Information
| Provider Information | |||||||||
| NPI: | 1720372782 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALLEN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7147 VISTA DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | WEST DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502669313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5158759925 | ||||||||
| FaxNumber: | 5158759923 | ||||||||
| Practice Location | |||||||||
| Address1: | 5950 UNIVERSITY AVE STE 131 | ||||||||
| Address2: | |||||||||
| City: | WEST DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5158759550 | ||||||||
| FaxNumber: | 5158759551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2011 | ||||||||
| LastUpdateDate: | 08/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | DO-04392 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 1160 | NE | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RP1001X | DO-04392 | IA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207R00000X | R9212 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | DO-04392 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 1160 | NE | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.