Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A106877 | CA |
NPI | 1023215357 |
---|---|
Provider Name | Jonathan Leslie Allen |
First Address | Redlands, CA 92374-4587 |
Second Address | Redlands, CA 92374-9706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 19/02/2020 |