Healthcare Provider Details

I. General information

NPI: 1811428469
Provider Name (Legal Business Name): KIMBERLY MARY ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ALZUPHAR MD

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26585 AGOURA RD STE 360
CALABASAS CA
91302-1958
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 818-846-8252
  • Fax:
Mailing address:
  • Phone: 310-301-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number305032
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA185372
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: