Provider Demographics
NPI:1598739161
Name:ALLEN, NATHAN HALE (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:HALE
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7601 HOSPITAL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5408
Mailing Address - Country:US
Mailing Address - Phone:916-737-5555
Mailing Address - Fax:916-689-8943
Practice Address - Street 1:7237 E SOUTHGATE DR
Practice Address - Street 2:SUITE C
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2637
Practice Address - Country:US
Practice Address - Phone:916-392-2290
Practice Address - Fax:916-392-3706
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2022-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG37098207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G370981Medicaid
CA00G370980Medicaid
CA00G370980Medicaid
00G370980Medicare PIN