Individual
ANDREW CHARLES ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
39000 BOB HOPE DR, HARRY & DIANE RINKER BUILDING, RANCHO MIRAGE, CA 92270-3221
(760) 568-2684
(760) 837-2262
Mailing address
PO BOX 1730, RANCHO MIRAGE, CA 92270-1058
(760) 568-2684
(760) 341-5832
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17164
CA
363AS0400X
Surgical Physician Assistant
PA17164
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17164
LICENSE #
CA
Enumeration date
09/25/2006
Last updated
04/05/2023
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