Provider Demographics
NPI:1376752097
Name:HOWARD H ALLISON M.D.
Entity type:Organization
Organization Name:HOWARD H ALLISON M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-832-3222
Mailing Address - Street 1:500 W EATON AVE
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-3422
Mailing Address - Country:US
Mailing Address - Phone:209-832-3222
Mailing Address - Fax:209-832-7610
Practice Address - Street 1:500 W EATON AVE
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3422
Practice Address - Country:US
Practice Address - Phone:209-832-3222
Practice Address - Fax:209-832-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51865207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G518650Medicaid
CA00G518650Medicare PIN
CA00G518650Medicaid