Individual
MATTHEW GENE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4002 VISTA WAY, OCEANSIDE, CA 92056-4506
(760) 724-8411
Mailing address
5050 AVENIDA ENCINAS, SUITE 200, CARLSBAD, CA 92008-4381
(760) 439-1963
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
52549
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52549
CALIFORNIA STATE PHYSICIAN ASSISTANT LICENSE
CA
Enumeration date
06/05/2015
Last updated
06/05/2015
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