Provider Demographics
NPI:1487983599
Name:ALLEN MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:ALLEN MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AVIONNE
Authorized Official - Middle Name:P
Authorized Official - Last Name:ALLEN-SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-667-0517
Mailing Address - Street 1:13106 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2152
Mailing Address - Country:US
Mailing Address - Phone:866-667-0517
Mailing Address - Fax:866-667-1206
Practice Address - Street 1:13106 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2152
Practice Address - Country:US
Practice Address - Phone:866-667-0517
Practice Address - Fax:866-667-1206
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-18
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAN407XMedicare PIN
CACV752BMedicare PIN
CAAN407ZMedicare PIN
CACV752AMedicare PIN