| Doctor Name: | MR. TRACY L MALAN |
| NPI Number: | 1154323020 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPT |
| License Number: | PT12940 |
| Business Practice Address: | 525 Melissa Ave Ste B Barstow, CA - 923113002 |
| Business Phone Number: | 7602561888 |
| Business Fax Number: | 7602562893 |
| Mailing Address: | 525 Melissa Ave, Ste B BARSTOW |
| State: | CA |
| Postal Code: | 923113002 |
| Phone Number: | 7602561888 |
| Fax Number: | 7602562893 |
| NPI Enumeration Date: | 08/11/2005 |
| NPI Last Update Date: | 08/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/23/2006 |
| NPI Reactivation Date: | 04/06/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT12940 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |