Individual
MR. JOHN WYNN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2755 HERNDON AVE, CLOVIS, CA 93611-6800
(559) 324-4000
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430079068
RAILROAD MEDICARE
CA
01
—
NA572
BS OF CA
CA
05
—
RN2929100
—
CA
Enumeration date
05/25/2006
Last updated
04/19/2013
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