Provider Demographics
NPI:1386638476
Name:AUSTIN, ALLEN E (O D)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:E
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:O D
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Mailing Address - Street 1:1 CITY BLVD W
Mailing Address - Street 2:SUITE #111
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3621
Mailing Address - Country:US
Mailing Address - Phone:714-634-0033
Mailing Address - Fax:714-634-2277
Practice Address - Street 1:1 CITY BLVD W
Practice Address - Street 2:SUITE #111
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3621
Practice Address - Country:US
Practice Address - Phone:714-634-0033
Practice Address - Fax:714-634-2277
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2017-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA10743T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8640461OtherCIGNA
CA113367OtherEYEMED VISION INSURANCE
CA1282OtherSUPERIOR
CAAUSTIN OPTOMETRYOtherUNITED HEALTHCARE
CASD0107430Medicaid
CA95-3314781OtherVISION CARE PLAN
CA48787OtherSAFEGUARD VISION INSURANC
CA9353511OtherPRIVATE HEALTHCARE SYSTEM
CA2289OtherMEDICA EYE SERVICES
CA95-3314781OtherTRICARE
CAAO7535OtherSPECTERA VISION INSURANCE
CA95-3314781OtherVISION CARE PLAN
CAWOP10743AMedicare PIN
CASD0107430Medicaid