Provider Information for 1366627812
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AMY A ALLEN
Sex: Female
NPI: 1366627812
Last Updated: 2021-03-10
Certification Date: 2021-03-10
Certification Date: 2021-03-10
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366627812 | ||||||||||||
| Enumeration Date | 2008-01-03 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 550 S VERMONT AVE 3RD FLOOR HEADQUARTERS LOS ANGELES, CA 90020-1912 United States Phone: 213-974-0596 | Fax:213-620-1405 | ||||||||||||
| Primary Practice Address | 2311 W EL SEGUNDO BLVD HAWTHORNE, CA 90250-3315 United States Phone: 323-241-6730 | Fax:323-242-1935 | ||||||||||||
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