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DAVID M ALLEN IDC
>> Military Health Care Provider >> Other Service ProvidersRegistrant NPI Number: 1578124194
Individual Registrant: DAVID M ALLEN IDC
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1ST MLG BLDG 150121 CAMP PENDLETON, CA 92055 US
Tel: 210-818-7207 Fax: --
Tel: 210-818-7207 Fax: --
Contact information for business:
2004 BURROUGHS ST SAN DIEGO, CA 92111-6619 US
Tel: 210-818-7207 Fax: --
Tel: 210-818-7207 Fax: --
Registration Information:
NPI: 1578124194
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171000000X | Other Service Providers Military Health Care Provider |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
