Individual
ALLEN JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
27001 MOULTON PKWY, # 103, LAGUNA HILLS, CA 92656-3600
(949) 362-4560
(949) 362-5521
Mailing address
27001 MOULTON PKWY, # 103, LAGUNA HILLS, CA 92656-3600
(949) 362-4560
(949) 362-5521
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A39085
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A39085
STATE LICENSE
CA
Enumeration date
12/12/2011
Last updated
12/12/2011
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