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NPI Code Detail

MEDICARE: DAVID ALLEN PH.D.

MEDICARE:   DAVID  ALLEN  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical NeuropsychologistPSY17710CA

General Provider Information

NPI Number : 1588974042
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ALLEN PH.D.
Provider Business Mailing Address
First Line : 2776 CARMAR DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-1009
Country : US
Telephone Number : 323-654-6567
Fax Number :
Provider Business Practice Location Address
First Line : 2776 CARMAR DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-1009
Country : US
Telephone Number : 323-654-6567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2010
Last Update Date : 11/17/2015

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