# S A ALLEN MD INC A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164698544
- **Authorized official:** ARCIE LOPEZ (MEDICAL BILLING COORDINATOR)
- **Authorized official phone:** (760) 863-1592

## Contact information

- **Practice address:** 79440 CORPORATE CENTER DR, \#110, LA QUINTA, CA 92253-7241
- **Practice address phone:** (760) 564-3533
- **Mailing address:** 79440 CORPORATE CENTER DR, \#110, LA QUINTA, CA 92253-7241
- **Mailing address phone:** (760) 564-3533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | A064634 | CA | Yes |

## Other

- **Enumeration date:** 05/05/2008
- **Last updated:** 07/07/2017