Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A123903 | CA |
NPI | 1811289200 |
---|---|
Provider Name | Allen Foulad |
First Address | Beverly Hills, CA 90212-3610 |
Second Address | Beverly Hills, CA 90212-3610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2011 |
Last Update Date | 02/12/2021 |