Provider Demographics
NPI:1225173909
Name:REBECCA ALLEYNE M.D.,INC.
Entity Type:Organization
Organization Name:REBECCA ALLEYNE M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALLEYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-491-4879
Mailing Address - Street 1:1045 ATLANTIC AVENUE
Mailing Address - Street 2:SUITE 712
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90813
Mailing Address - Country:US
Mailing Address - Phone:562-491-4879
Mailing Address - Fax:562-491-7987
Practice Address - Street 1:1045 ATLANTIC AVENUE
Practice Address - Street 2:SUITE 712
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90813
Practice Address - Country:US
Practice Address - Phone:562-491-4879
Practice Address - Fax:562-491-7987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1356389050OtherNPI - PERSONAL
CAA79024OtherLIC. PHYSICAN & SURGEON