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General NPI Number Information
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NPI Number | 1720780687
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Entity Type | Individual
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Provider Name | ALLISON DEPAS MD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 11234 ANDERSON ST
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City | LOMA LINDA
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State | CA
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Zip | 92350-1716
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Country | US
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Telephone | 909-651-5353
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Fax |
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Provider Business Mailing Address
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Address Line | 885 TIVERTON DRIVE
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-825-6373
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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 | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | A204918
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License Number State | CA
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