Healthcare Provider Details

I. General information

NPI: 1639118359
Provider Name (Legal Business Name): LATRICE M ALLEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23600 TELO AVE STE 270
TORRANCE CA
90505-4037
US

IV. Provider business mailing address

3440 LOMITA BLVD STE 240
TORRANCE CA
90505-4871
US

V. Phone/Fax

Practice location:
  • Phone: 310-539-5060
  • Fax: 310-539-7899
Mailing address:
  • Phone: 310-539-5060
  • Fax: 310-539-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA63978
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: