Provider Demographics
NPI:1306892021
Name:ALLEN, ERIC JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAMES
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ANTELOPE LN
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6301
Mailing Address - Country:US
Mailing Address - Phone:831-883-3822
Mailing Address - Fax:
Practice Address - Street 1:3401 ENGINEER LN
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-7200
Practice Address - Country:US
Practice Address - Phone:831-883-3822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG71308Medicare UPIN