Provider Demographics
NPI:1285678326
Name:ALLEN, EDWARD CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CHARLES
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3807 UNION AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-2400
Mailing Address - Country:US
Mailing Address - Phone:661-326-0333
Mailing Address - Fax:661-326-1633
Practice Address - Street 1:3807 UNION AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-2400
Practice Address - Country:US
Practice Address - Phone:661-326-0333
Practice Address - Fax:661-326-1633
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2011-06-22
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Provider Licenses
StateLicense IDTaxonomies
CAC399270207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C399270Medicaid
CA00C399270Medicaid