IndividualActive
Jon Mallen-St. Clair, M.D.
NPI 1134410038 · Plastic Surgery within the Head & Neck (Otolaryngology) Physician · Los Angeles, CA
Provider details
- NPI number
- 1134410038
- Entity type
- Individual
- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
- Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianPrimary207YX0007XLicense A125470 (CA)
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
8635 W 3rd St Ste 590w
Los Angeles, CA 90048-6163
Phone: (310) 423-1220
Fax: (310) 423-1230
Approximate (ZIP-level) locationGet directions
Mailing address
8635 W 3rd St Ste 590w
Los Angeles, CA 90048-6163
Registry dates
- Enumerated
- 2011-04-26
- Last updated
- 2021-01-21
- Certified
- 2021-01-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.