Individual
DERRICK ROSS ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 WASHINGTON ST, 510, SAN DIEGO, CA 92103-2231
(619) 849-1729
Mailing address
P.O. BOX 34307, SAN DIEGO, CA 92163-4307
(888) 727-1270
(877) 883-5176
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A69840
CA
2085R0204X
Vascular & Interventional Radiology Physician
A69840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A698400
—
CA
Enumeration date
05/23/2006
Last updated
04/12/2021
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