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General NPI Number Information
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NPI Number | 1508843368
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Entity Type | Organization
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Legal Business Name | SUSAN PARK ALLEN MD INC
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 320 SUPERIOR AVE STE 270
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2778
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Country | US
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Telephone | 949-645-9100
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Fax | 949-650-1135
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Provider Business Mailing Address
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Address Line | 320 SUPERIOR AVE STE 270
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2778
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Country | US
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Telephone | 949-645-9100
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Fax | 949-650-1135
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN PARK ALLEN
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Credential | MD
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Telephone | 949-645-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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