Provider Demographics
NPI:1265837421
Name:ALLAN, NANCY ELIZABETH (LAC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELIZABETH
Last Name:ALLAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 OCEAN AVE UNIT 1407P
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-1439
Mailing Address - Country:US
Mailing Address - Phone:310-487-2300
Mailing Address - Fax:
Practice Address - Street 1:201 OCEAN AVE UNIT 1407P
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90402-1439
Practice Address - Country:US
Practice Address - Phone:310-487-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16206171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist