Healthcare Provider Details

I. General information

NPI: 1730610403
Provider Name (Legal Business Name): ROBERT WALDO ALLEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 NIELSON ST STE 125
WATSONVILLE CA
95076-2491
US

IV. Provider business mailing address

38 CUESTA VISTA DR
MONTEREY CA
93940-4306
US

V. Phone/Fax

Practice location:
  • Phone: 831-768-6266
  • Fax: 831-768-6289
Mailing address:
  • Phone: 610-213-0986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number176876
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: