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General NPI Number Information
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NPI Number | 1528199239
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Entity Type | Individual
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Provider Name | ANTHONY ALEXANDER ALLEN C. PED.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 230 W CONTINENTAL RD STE 416
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City | GREEN VALLEY
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State | AZ
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Zip | 85622-3591
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Country | US
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Telephone | 520-399-1365
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Fax | 520-696-3338
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Provider Business Mailing Address
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Address Line | 18783 S AVENIDA RIO VELOZ
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City | SAHUARITA
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State | AZ
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Zip | 85629-8172
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Country | US
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Telephone | 520-304-1774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20011
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License Number State | AZ
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