Individual
KIM ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8140 SUNLAND BLVD, SUN VALLEY, CA 91352-3948
(818) 582-8832
Mailing address
8140 SUNLAND BLVD, SUN VALLEY, CA 91352-3948
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1252000517
RADT-CCAPP
—
Enumeration date
06/07/2017
Last updated
06/07/2017
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