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Individual

DR. ALLIE KIERAN BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1516 COTNER AVE, LOS ANGELES, CA 90025-3303
(310) 445-2951
(310) 479-1459
Mailing address
1516 COTNER AVE, LOS ANGELES, CA 90025-3303
(310) 445-2951
(310) 479-1459

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A89524
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A895240
CA
Enumeration date
02/07/2007
Last updated
05/11/2009
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