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NPI Code Detail

MEDICARE: TINA ALLEE M.D.

MEDICARE:   TINA  ALLEE  M.D.
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
12084P0800XPsychiatry PhysicianA109503CA

General Provider Information

NPI Number : 1386960904
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA ALLEE M.D.
Provider Business Mailing Address
First Line : 3151 AIRWAY AVE STE R
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-4627
Country : US
Telephone Number : 949-930-3107
Fax Number : 949-930-3107
Provider Business Practice Location Address
First Line : 3151 AIRWAY AVE STE R
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-4627
Country : US
Telephone Number : 949-930-3107
Fax Number : 949-930-3107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2010
Last Update Date : 11/26/2024

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