Healthcare Provider Details

I. General information

NPI: 1528305828
Provider Name (Legal Business Name): ANDREW R ALLMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2013
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 TEXAS AVE
LOS BANOS CA
93635-3453
US

IV. Provider business mailing address

308 MOSSY ROCK DR
MCKINNEY TX
75071-5663
US

V. Phone/Fax

Practice location:
  • Phone: 209-384-6495
  • Fax:
Mailing address:
  • Phone: 910-797-0984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA67585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: