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DAVID M ALLEN IDC

>> Military Health Care Provider >> Other Service Providers

Registrant NPI Number: 1578124194

Individual Registrant:
 DAVID M ALLEN IDC
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: --

Contact information for business:
2004 BURROUGHS ST  SAN DIEGO, CA 92111-6619 US
Tel: 210-818-7207  Fax: --

Registration Information:
NPI: 1578124194
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171000000XOther Service Providers
Military Health Care Provider

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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