Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Andrew David Mamalis, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1023350402

Dr. Andrew David Mamalis, MD is a Dermatology in Modesto, California. Graduated from University of California, Davis School of Medicine in 2016, 10 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment.

Years since qualifying
10
Trained at
University of California, Davis School of Medicine
In the registry since
2013
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4125 Bangs Ave
Modesto, CA 95356-8713
Phone: (209) 735-5510
Fax: (209) 557-1614
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1023350402
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2013
Last updated in NPPESMarch 5, 2024
Certification dateMarch 5, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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