Individual
DAVID E ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1 SHRADER ST., SUITE 650, SAN FRANCISCO, CA 94117
(415) 221-0665
(415) 221-0687
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 17794
CA
363AS0400X
Surgical Physician Assistant
PA 17794
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PA177940
PPIN
CA
Enumeration date
12/28/2006
Last updated
05/22/2018
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