Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC11841 | CA |
NPI | 1760563993 |
---|---|
Provider Name | Dr. Michael Allen |
First Address | Mission Viejo, CA 92691-3934 |
Second Address | Mission Viejo, CA 92691-3934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 11/02/2021 |