Healthcare Provider Details

I. General information

NPI: 1801275391
Provider Name (Legal Business Name): RACHAEL ANN ALLEN D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHAEL ANN HAYDEN D.O

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 CARROLL CANYON RD STE 210
SAN DIEGO CA
92121-3758
US

IV. Provider business mailing address

NAVAL HOSPITAL CAMP PENDLETON 200 MERCY CIRCLE
CAMP PENDLETON CA
92055
US

V. Phone/Fax

Practice location:
  • Phone: 800-765-2737
  • Fax:
Mailing address:
  • Phone: 760-725-1288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number20A14877
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: