ETHAN R ALLEN (NPI# 1114016912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114016912 |
| Entity Type | Individual |
| Full Name | ETHAN R ALLEN |
| Other Name | ETHAN ROY ALLEN |
| Credential | D.O. |
| Practice Address |
12820 Studebaker Rd 101 Norwalk CA 90650-2578 |
| Practice Telephone | 5628687873 |
| Practice Fax Number | 5628687182 |
| Mailing Telephone | 5628687873 |
| Mailing Fax Number | 5628687182 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2008-04-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20A1705 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 020A17050 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215570460 | Ethan Allen | Behavioral Analyst | 90 Hospital Dr, Athens, OH 45701-2301 | 2019-10-21 |
| Street Address |
12820 STUDEBAKER RD 101 |
| City | NORWALK |
| State | CA |
| Zip Code | 90650-2578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619973401 | Gregory Grant Smith | Dentist | 12820 Studebaker Rd, Ste 202, Norwalk, CA 90650-2582 | 2005-06-27 |
| 1396153425 | Ray Gokaldas Md A Professional Corporation | Specialist | 12820 Studebaker Rd, Suite # 201, Norwalk, CA 90650-2578 | 2014-08-01 |
| 1861832149 | Kyoung Min Han,dpm PC Inc. | Podiatrist | 12820 Studebaker Rd, Suite 200, Norwalk, CA 90650-2578 | 2013-07-01 |
| 1811161771 | Mark Scott Linam | Podiatrist | 12820 Studebaker Rd, Suite 200, Norwalk, CA 90650-2578 | 2008-04-22 |
| 1891877056 | Eufrocino Cabotaje Martinez | Surgery | 12820 Studebaker Rd, Suite 100, Norwalk, CA 90650-2578 | 2006-10-19 |
| 1609987973 | Ray Gokaldas | Specialist | 12820 Studebaker Rd, Suite # 201, Norwalk, CA 90650-2578 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420316 | Ricky Chavez | Occupational Therapist | 13603 Halcourt Avenue, Norwalk, CA 90650 | 2020-09-03 |
| 1326671652 | Ryan Ly | Psychologist | 11400 Bloomfield Blvd, Norwalk, CA 90650 | 2020-02-14 |
| 1710416177 | Ricky O Lee | Pharmacist | 11401 S. Bloomfield Ave, Norwalk, CA 90650 | 2017-06-08 |
| 1689108847 | Eliana Segura | Student in an Organized Health Care Education/Training Program | 12440 Firestone Ave Blvd., 3020, Norwalk, CA 90650 | 2017-04-14 |
| 1396282752 | Martin Sanchez Torres | Specialist/Technologist, Other | 14003 Summer Ave, Norwalk, CA 90650 | 2017-01-24 |
| 1952859837 | Fatimah Busran | Social Worker | 11401 South Bloomfield Avde., Norwalk, CA 90650 | 2016-09-20 |
| 1760939383 | Andy Chang | Licensed Psychiatric Technician | 12440 East Imperial Highway, Suite 116, Norwalk, CA 90650 | 2016-09-01 |
| 1548634322 | Leslie Yesenia Lazo | Student in an Organized Health Care Education/Training Program | 12440 E. Firestone Blvd, Norwalk, CA 90650 | 2015-11-17 |
| 1306247994 | Ruth Vergara | Student in an Organized Health Care Education/Training Program | 21520 S. Pioneer Blvd., Suite 110, Hawaiian Gardens, CA 90650 | 2014-09-15 |
| 1265854251 | Sungmin Yee | Acupuncturist | 12706 Bloomfield Ave, Apt. 135, Norwalk, CA 90650 | 2014-01-10 |
| Find all providers in zip 90650 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528508827 | Manuel Sacpano Md Inc | Family Medicine | 13222 Bloomfied Ave, Norwalk, CA 90650-3249 | 2017-03-06 |
| 1629415484 | Elyse C Tinker | Family Medicine | 257 Benedict Ave Ste 1, Norwalk, OH 44857-2715 | 2013-06-03 |
| 1568760239 | Shine Healthcare Inc. | Family Medicine | 12371 Imperial Hwy, Norwalk, CA 90650-3129 | 2011-03-04 |
| 1982880845 | Daniel Uribe Md A Professional Corporation | Family Medicine | 13307 San Antonio Dr, Norwalk, CA 90650-2970 | 2008-01-10 |
| 1194936930 | Seema Lynn Mishra | Family Medicine | 3099 W State Route 113, Norwalk, OH 44857-9606 | 2007-05-24 |
| 1982751814 | Galal Samuel Gough | Family Medicine | 13132 Studebaker Rd Ste 9, Norwalk, CA 90650-2575 | 2007-01-04 |
| 1255404786 | Seth M Ruggles | Family Medicine | 348 Milan Ave, Suite 2, Norwalk, OH 44857-0000 | 2006-11-15 |
| 1154403624 | Daniel K Wong | Family Medicine | 13939 San Antonio Dr, Norwalk, CA 90650-4036 | 2006-10-20 |
| 1811085814 | Charles S Resseger | Family Medicine | 853 South Norwalk Road, Norwalk, OH 44857 | 2006-10-11 |
| 1619065141 | Stephanie Francis Gibson | Family Medicine | 85 Benedict Ave, Suite 101, Norwalk, OH 44857-2112 | 2006-10-10 |
| Find all providers in NORWALK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.