Provider Demographics
NPI:1770599706
Name:ALLEN, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
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Mailing Address - Street 1:3160 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3160 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5219
Practice Address - Country:US
Practice Address - Phone:916-733-5336
Practice Address - Fax:916-733-5385
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA26723207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1288781OtherGREAT WEST
CA3042613OtherCIGNA
CA000810342855OtherPHCS
CA00A267230OtherBLUE SHIELD
CA500260OtherHEALTH NET
CA00A267230Medicaid
CAA26723OtherBLUE CROSS
CA90026131OtherPACIFICARE
CA1073199OtherFIRST HEALTH
CA4507060OtherAETNA
CA792441OtherUNITED HEALTHCARE
CAMCMG123300OtherWESTERN HEALTH ADVANTAGE
CA1648OtherINTERPLAN
CA1648OtherINTERPLAN
CA1073199OtherFIRST HEALTH