Individual
SUSAN PARK ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
320 SUPERIOR AVE STE 270, NEWPORT BEACH, CA 92663-2778
(949) 645-9100
(949) 650-1135
Mailing address
320 SUPERIOR AVE STE 270, NEWPORT BEACH, CA 92663-2778
(949) 645-9100
(949) 650-1135
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
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