Healthcare Provider Details

I. General information

NPI: 1326151465
Provider Name (Legal Business Name): FRANK ALLEN PAUL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58375 29 PALMS HWY
YUCCA VALLEY CA
92284-5813
US

IV. Provider business mailing address

6530 LA CONTENTA RD STE 100
YUCCA VALLEY CA
92284-7313
US

V. Phone/Fax

Practice location:
  • Phone: 760-365-9305
  • Fax: 866-732-0113
Mailing address:
  • Phone: 760-820-9229
  • Fax: 760-820-9228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101011088
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number3473
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number12439
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberDO2050
License Number StateNV
# 5
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20A7307
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: