Healthcare Provider Details

I. General information

NPI: 1205870540
Provider Name (Legal Business Name): H ALLEN HOOPER, M.D. A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 ANTONIO AVE
CAMARILLO CA
93010-1414
US

IV. Provider business mailing address

PO BOX 660879
ARCADIA CA
91066-0879
US

V. Phone/Fax

Practice location:
  • Phone: 805-389-5648
  • Fax: 805-383-7446
Mailing address:
  • Phone: 626-447-0296
  • Fax: 626-447-6036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HENRY ALLEN HOOPER
Title or Position: OWNER
Credential: M.D.
Phone: 805-988-2843