Provider Demographics
NPI:1144244245
Name:MORRISON, ALLAN R (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:R
Last Name:MORRISON
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 1:4340 OVERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4117
Mailing Address - Country:US
Mailing Address - Phone:310-559-4411
Mailing Address - Fax:310-559-5147
Practice Address - Street 1:4340 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4117
Practice Address - Country:US
Practice Address - Phone:310-559-4411
Practice Address - Fax:310-559-5147
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA22044Medicare UPIN