Provider Demographics
NPI:1063456978
Name:FELIX, ALLEN CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:CHARLES
Last Name:FELIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8990 GARFIELD ST STE 8
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3922
Mailing Address - Country:US
Mailing Address - Phone:951-248-0485
Mailing Address - Fax:951-248-9267
Practice Address - Street 1:8990 GARFIELD ST STE 8
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3922
Practice Address - Country:US
Practice Address - Phone:951-248-0485
Practice Address - Fax:951-248-9267
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG075952207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00016Medicare UPIN
ZZZ05463ZMedicare PIN