Provider Demographics
NPI:1154452308
Name:ALLEN, GEORGE CYRUS JR (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:CYRUS
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:10921 WILSHIRE BLVD
Mailing Address - Street 2:#614
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3906
Mailing Address - Country:US
Mailing Address - Phone:310-209-7595
Mailing Address - Fax:310-209-3335
Practice Address - Street 1:10921 WILSHIRE BLVD
Practice Address - Street 2:#614
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3906
Practice Address - Country:US
Practice Address - Phone:310-209-7595
Practice Address - Fax:310-209-3335
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2015-09-16
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Provider Licenses
StateLicense IDTaxonomies
CAA800212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry