Provider Demographics
NPI:1841432507
Name:JAHROUMI, ALLEN A (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:A
Last Name:JAHROUMI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23512 MADERO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2743
Mailing Address - Country:US
Mailing Address - Phone:949-583-1600
Mailing Address - Fax:949-454-8067
Practice Address - Street 1:23512 MADERO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2743
Practice Address - Country:US
Practice Address - Phone:949-583-1600
Practice Address - Fax:949-454-8067
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB209786Medicare PIN