Provider Demographics
NPI:1699731513
Name:WARNER, ALLEN S (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:S
Last Name:WARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2699 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2710
Mailing Address - Country:US
Mailing Address - Phone:562-426-3333
Mailing Address - Fax:562-426-5483
Practice Address - Street 1:2699 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2710
Practice Address - Country:US
Practice Address - Phone:562-426-3333
Practice Address - Fax:562-426-5483
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG34765207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46067Medicare UPIN