Individual
SUSAN PARK ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
G061446
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G61440
MEDICAL
CA
01
—
00G614460
BLUE SHIELD
—
Enumeration date
12/21/2005
Last updated
12/05/2025
Update your record
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