MEDICARE: WARREN CURTIS ALLEN LVN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator
2	282NR1301X	Rural Acute Care Hospital
3	314000000X	Skilled Nursing Facility
4	164X00000X	Licensed Vocational Nurse	239005	CA

General Provider Information

NPI Number	:	1033746680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WARREN CURTIS ALLEN LVN

Provider Business Mailing Address
First Line	:	1631 MILL STREAM DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-1780
Country	:	US
Telephone Number	:	559-572-1944
Fax Number	:

Provider Business Practice Location Address
First Line	:	1631 MILL STREAM DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-1780
Country	:	US
Telephone Number	:	559-572-1944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2020
Last Update Date	:	03/24/2020

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