Mallavia OD PC
NPI 1417169251 · Optometrist · Page, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mallavia OD PC is a Optometrist organization in Page, AZ (NPI 1417169251).
Provider details
- NPI number
- 1417169251
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- David Mallavia, President(928) 645-2772
- License
- 1379 (AZ)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-05-04
- Last updated
- 2007-12-31
Frequently asked questions
- What is Mallavia OD PC's NPI number?
- Mallavia OD PC's National Provider Identifier (NPI) is 1417169251, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mallavia OD PC?
- Mallavia OD PC is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Mallavia OD PC located?
- Mallavia OD PC's practice location on file with NPPES is 124 Sixth Ave, Page, AZ 86040-1806.
- What is Mallavia OD PC's phone number?
- The practice phone number listed in the NPPES registry for Mallavia OD PC is (928) 645-2772.
- Does Mallavia OD PC accept Medicare?
- Mallavia OD PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mallavia OD PC?
- The authorized official listed on Mallavia OD PC's NPPES record is David Mallavia, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mallavia OD PC's NPI active?
- Yes — Mallavia OD PC's NPI (1417169251) is active in the NPPES registry as of the last update on 2007-12-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.