| S A Allen Md Inc A Medical Corporation | |
|
79440 Corporate Center Dr #110 La Quinta CA 92253-7241 | |
| (760) 564-3533 | |
| Not Available |
| Full Name | S A Allen Md Inc A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 79440 Corporate Center Dr, La Quinta, California |
| Authorized Official Name and Position | Arcie Lopez (MEDICAL BILLING COORDINATOR) |
| Authorized Official Contact | 7608631592 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S A Allen Md Inc A Medical Corporation 79440 Corporate Center Dr #110 La Quinta CA 92253-7241 Ph: (760) 564-3533 | S A Allen Md Inc A Medical Corporation 79440 Corporate Center Dr #110 La Quinta CA 92253-7241 Ph: (760) 564-3533 |
| NPI Number | 1164698544 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 07/07/2017 |
| Medicare PECOS PAC ID | 8123188752 |
|---|---|
| Medicare Enrollment ID | O20081126000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164698544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | A064634 (California) | Primary |
| Provider Name | Shawn A Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598774846 PECOS PAC ID: 3779588629 Enrollment ID: I20060927000247 |
Edward A. Ruiz Md, Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 47110 Washington St Ste 203, La Quinta, CA 92253 Phone: 760-564-9205 Fax: 760-771-6243 | |
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