Provider Demographics
NPI:1346304268
Name:ALLER, RAYMOND DONALD (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:DONALD
Last Name:ALLER
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:PO BOX 2168
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-2168
Mailing Address - Country:US
Mailing Address - Phone:760-801-3760
Mailing Address - Fax:760-295-2907
Practice Address - Street 1:850 ORA AVO DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-6540
Practice Address - Country:US
Practice Address - Phone:760-801-3760
Practice Address - Fax:760-295-2907
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG034932207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine